A Claims Representative accepts and reviews applications for insurance and provides information to insurance agents. Assists insurance customers, answers questions and processes requests to change or cancel policies. May assist with insurance claims that are disputed, review claims and policy coverage and help to negotiate agreements between customers and an insurance company.
6-month project with possible extension based on performance Key Responsibilities Handle incoming customer calls related to fraud and claims. Investigate potentially fraudulent activity and assist with resolving customer concerns. Identify and submit customer complaints when applicable. Navigate multiple systems and applications to research information and complete assigned work. Independently prioritize daily responsibilities while meeting team and operational expectations. Provide guidance and subject matter expertise to less experienced team members on complex fraud and claims matters. Recommend process and tool improvements to increase efficiency within fraud and claims operations. Support team performance and cross-functional operational activities. Use strong judgment and decision-making skills when handling sensitive customer and fraud-related matters. Required Qualifications 2+ years of experience in customer service, financial services, fraud, claims, investigations, or a related field. Spanish/English bilingual proficiency 1+ year of call center or phone-based customer service experience. Strong communication, problem-solving, and decision-making skills. Ability to work independently with limited supervision. Ability to navigate multiple systems and applications efficiently. Preferred Qualifications Fraud and claims operations experience. Proficiency with Microsoft Office, including Excel and Outlook. Experience working in a contact center or other high-volume phone environment. Strong initiative and ability to identify opportunities for process improvement. Equal Opportunity Employer / Disabled / Protected Veterans The Know Your Rights poster is available here: https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf The pay transparency policy is available here: https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required. We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team. AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
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//e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
