The Claims Processing Representative is responsible for accurately and efficiently processing claims, verifying claim information, and ensuring alignment with warranty coverage. This role involves managing inbound calls from customers, dealerships, sales agents, and technicians while maintaining exceptional customer service standards.

Essential Functions

• Receive and process claims through inbound phone calls and online claim submission forms, ensuring all necessary information is captured accurately and promptly.
• Review and analyze claims against warranty terms and conditions, ensuring that all claims are processed in strict adherence to the company’s policies and contractual guidelines.
• Evaluate and resolve claim discrepancies, investigate potential issues, escalate complex matters when necessary, and ensure clear and fair resolutions in line with warranty coverage.
• Build Trust through communicating professionally and clearly with customers, vendors, and internal teams to gather necessary information, provide claim updates, and answer questions regarding claim status or eligibility.
• Accurately document all claim activities, customer interactions, and resolutions in the system, ensuring a complete and detailed record for future reference and audits.
• Manage personal attendance and ensure availability during scheduled work hours. Adhere to shift schedules and promptly notify supervisors of any potential attendance issues.
• Provide exceptional customer service by maintaining a positive and empathetic attitude in all customer interactions, and handling issues in a timely and professional manner.
• Work closely with other departments (such as escalations, technical support, or B2B teams) to ensure the smooth processing and resolution of claims, collaborating on any discrepancies or issues that arise.
• Stay informed on company policies, warranty terms, and product offerings, ensuring claims are processed efficiently and in compliance with all updated standards.
• Be responsive by prioritizing daily workload, managing claim volume, and meeting processing deadlines while maintaining high accuracy and efficiency.

• Ability to analyze claims, identify discrepancies, and resolve issues accurately and efficiently.
• Experience in Microsoft Office, Salesforce, and claims management software for managing workflows and claim data.
• Organizational and multitasking skills, ensuring accuracy and efficiency in a fast-paced environment.
• Effective written and verbal communication for reporting, correspondence, and resolving complex claims issues.
• Experience maintaining confidentiality and adhering to data security standards in compliance with regulations.
• Competency in financial calculations and cost estimation for accurate claims evaluation.
• Ability to engage with diverse individuals and resolve claims-related matters while maintaining positive relationships.
• Capable of making informed decisions independently, aligning with policies and company objectives.

Physical Demands

• Regularly required to sit, talk, and hear.
• Frequently required to stand, walk, use hands, and reach with arms.
• Occasionally required to stoop, kneel, crouch, or crawl.
• Must occasionally lift and/or move up to 10 pounds.
• Ability to view a computer monitor and phone screen clearly at 20 inches or less.