Sr. Specialist, Call Ctr Claims

Primary Role

The Sr. Claims Specialist represents both Homeowner Services and the client(s). The role is responsible for customer service claims adjudication activities, including repair claims processing via call handling, account maintenance, problem resolution, and claims follow-up activities in a blended environment handling both inbound and outbound customer claim calls. Claims Specialists will work closely with supervisors and coaches to meet quality assurance guidelines for professionalism, claim accuracy/customer service techniques and customer engagement.

Key Accountabilities

Functional Expertise:
• Assist existing customers with account questions and scheduling repair or maintenance service while following claims processes for accurate adjudication and service fee collections.
• When the opportunity is presented retain/sell home warranty products and services to residential and/or commercial customers by explaining new and current features and benefits while following quality standards, scripting processes and procedures as trained and documented in the company policy and procedure manual.
• Navigate systems efficiently and enter data accurately while resolving customer needs.
Business Acumen:
• Maintain a thorough understanding of customer account/claims processes (i.e. billing, claim adjudication, payments, service fees) and the benefits of the HOS suite of products and services.
• Ability to successfully resolve customer questions and/or concerns quickly by clarifying issues, researching, and exploring answers and alternative solutions, and implementing appropriate solutions.
Engagement:
• Reflect our company Values and contributes to our positive, results-driven culture.
• Possess excellent interpersonal skills, diplomacy, and patience while interacting with customers, peers, management, and other departments. Comfortable with receiving coaching feedback and monitoring of calls.
• Take personal responsibility, exploring opportunities to add value, contributing ideas, and participating in activities to continuously improve customer satisfaction and productivity.
• Thorough understanding of our claims process, provider journey and field operations to help resolve issues when customers call. Provide feedback on ways to improve the process or what is working well to maintain a favorable customer experience.
• Maintain company KPIs daily, weekly, monthly. This includes but not limited to C-SAT, QA, retention, claims accuracy, etc.
• Maintain and exceed client and customer expectations through professional interactions on inbound and outbound calls.
• Demonstrate a personal commitment to promoting and providing exceptional customer service.

Knowledge/Skills

Knowledge: Required:
• Proficient typing and computer application skills (minimum of 40 wpm)
• Strong attention to detail with handling customer claims and the ability to multitask while speaking with a customer on the phone.
• Maintain a high level of application, process, and water and sewer utility knowledge.
• Easily adapt to change while balancing multiple priorities
• Ability to work a continuously flexible schedule including evenings, weekends, and holidays with punctuality and consistent work attendance. Current hours of operation are 6:00 am – 7:00 pm Monday - Saturday
• Motivation for producing accurate customer claims and retaining customers. Adhering to set computer guided scripts and procedures
• Excellent verbal and written communications skills, effective listening skills, and ability to identify needs through phone conversation

Preferred:
• Knowledge or familiarity with HVAC equipment/Water and Sewer and standard concepts
• Proven track record of exceeding quotas and business goals
• Proven ability to work successfully in a results-oriented environment
• Bilingual (Spanish)
• Ability to handle a high call volume environment while maintaining high performance.

Experience/Education

• Education:
  • Required: High School or GED
  • Preferred: Associate Degree, some college courses
• Skills:
  • Advanced skills in SQL and Microsoft Excel.
  • Supporting skills: MS Office: PowerPoint, Word, and Outlook.
  • Adept at managing multiple priorities and tasks in a fast-paced environment.
  • Experienced with setting up and maintenance of databases.
  • Accurately analyze and collect data for various types of business reports.
  • Strong balance of quantitative and analytical abilities paired with excellent communication and interpersonal skills.

• Experience:

  • Required: 2-4 years’ experience in related business environment or Customer Servicw

  • Preferred:

    • Previous work experience in a fast-paced Call Center environment
    • Experience accurately capturing details of phone conversation on paper and in a computer application.
    • Experience with claims adjudication, probing questions and service fee collection

Travel Requirements

• 5%

Work Environment

• Working Conditions/Physical Requirements: Claims Support Specialists may sit or stand, but are required to remain at their desks except for scheduled lunch and breaks; Office Environment

Other

• Incorporate Homeowner Services Mission and Vision in daily management.
• Vision: Purpose-driven, people-powered, customer-obsessed trusted partner for every home.
• Mission: To keep our customers’ lives flowing by making their home lives easier.

Competencies