Claims Processor

The Reserves Network is a full service staffing firm specializing in light industrial, manufacturing, and office placement.   St. Petersburg, FL area insurance company seeks experienced Claims Adjuster bilingual is a plus.

 

         Pay $16.35/hr.

         Hours vary between 8am-5pm, 9am-6pm, or 10am-7pm Mon.-Fri. Possible Sat. 9am-6pm.

         Temp to hire for the right candidate.

 

Duties Include:

         Respond to and resolves issues encountered by clients and customers in a timely and positive manner. This involves mostly inbound calls, but may also include outbound calls, email, fax, and chat.

         Ensures that all customers/clients are responded to in a timely manner, and meaningful solutions are proposed and implemented.

         Adheres to standards for effective job performance and development.

         Gains and maintains in depth understanding of VPS products, clients, systems and applications.

         Ensures compliance with ISO, SOX, PCI and other applicable internal and external audits and or contractual obligations.

         Adjust and document all claims within departmental standards and in accordance to applicable laws and policy provisions to ensure compliance with all departments of insurance regulations.

         Process claims with accuracy to confirm coverage by reviewing all available tools including contract and web based applications to resolve complex issues and refer any issues as necessary to senior level adjusters or supervisor.

         Adjudicate claims with accuracy, by working directly with the repair facility, inspection and parts vendors and multiple other resources to ensure proper claims adjudication within departmental standards.

         Document reasons for denial or authorization of claim in accordance with policy conditions and quoting policy language to the correct parties in a timely manner within authority level and seek approval when above authority.

 

Requirements Include:

         Must have stable work history with successful longevity and stability at previous employer.

         Excellent written and verbal skills to communicate with team members, management, customers, and counselors.

         Ability to work in a team to generate ideas and resolve problems.

         Ability to process time sensitive data and information from multiple sources, including data from mainframe systems, makes decisions based on the data, and effectively communicates the related actions to a broad audience.

         Proficiency of computer navigation and Microsoft Office 2003 or later versions & Microsoft Windows XP or later versions.

         Ability to pass licensing requirements within 18 months and maintain appropriate licenses.

         High School Diploma or GED.

 

What we offer:

         Competitive base pay depending on experience

         Medical, Dental, and Vision Insurance

         401k plan for tenured associates

         Full time employment with overtime opportunity

         Weekly pay with direct deposit

         Uncapped referral bonuses for our employees