Claims Experience Specialist

Full Time Operations Remote OK
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The Claims Experience Specialist is a pivotal role, bridging the Claims Team – Claims Pod-Service Team, along with providing dedicated support and expertise to ensure the smooth operation of the claims handling process. This role involves a hybrid of administrative, customer service, and technical duties, serving as a key point of contact for both internal stakeholders and external customers. The Claims Experience Specialist will work closely with the Claims Team, Claims Pod and other departments to provide timely and efficient claims support.  

Availability: 9:00 am – 6:00 pm EST (Monday – Friday)

Claims Handling Support:

  • Assist with the processing of insurance claims, including data entry, documentation, and file management within the claims management system. 
  • Act as the primary point of contact for incoming calls and inquiries related to claims, providing prompt and accurate assistance to policyholders, agents, and claimants. 
  • Document all communications and interactions with claimants, ensuring thorough and accurate records are maintained in the claims management system. 
  • Provide initial triage and assessment of incoming claims and identify urgent issues or escalations and routing them to the appropriate team members for further handling. 

Customer Service and Communication:

  • Serve as the front-line representative for claims-related inquiries, responding to emails, phone calls, and other forms of communication promptly and professionally.
  • Act as a liaison between the Claims Pod and other internal departments, ensuring seamless communication and collaboration to resolve customer issues and inquiries.
  • Manage the and email inbox, responding to customer inquiries, processing requests, and directing messages to the appropriate team members as needed.

Payment Processing and Notification:

  • Coordinate and process claims payments, working closely with the Payments Team, to ensure timely and accurate processing of claim payments, including communications with claimants of payment status and resolving payment-related inquiries.
  • Monitor payment notifications and follow-up on outstanding payments or discrepancies, escalating issues to management or relevant stakeholders as necessary.

Data Management and Updates:

  • Facilitate data requests and updates to claim file data, working closely with the Data and Analytics Team to ensure accuracy and completeness of claims information.
  • Maintain organized and up-to-date records of claims-related documentation, correspondence, and transactions within the claims management system

Administrative Support:

  • Assist with administrative tasks related to claims processing, such as organizing physical mail and handling other ad-hoc administrative duties as assigned.
  • Attend and actively participate in customer experience meetings, claims meetings, and other relevant team meetings to stay informed about departmental updates, training opportunities, and best practices.

Other Duties as Needed:

  • This role may include additional duties or responsibilities as determined by management to support the needs of the Claims Team or Claims Pod Service Team. Oversight and guidance will be provided by the VP of Claims Operations to ensure the successful execution of job duties and adherence to departmental standards and procedures.

Superpowers we are looking for! 

  • Adjuster’s license required. 
  • Bachelor’s degree in business administration, finance, or a related field (preferred) or equivalent experience in the insurance industry. 
  • Prior experience in an administrative, customer service or adjusting role, preferably within a TPA or Insurance-related industry.
  • Strong communication skills, both verbal and written, with the ability to effectively interact with internal and external stakeholders.
  • Detail-oriented with excellent organizational and time management skills.
  • Proficiency in using Microsoft Office applications and claims management systems.
  • Ability to work independently and collaboratively in a fast-paced environment.
  • Willingness to learn and adapt to new processes and technologies. 

What to expect! 
Our hiring process generally consists of 3 phases.

  • Phase 1: Qualified candidates will first meet with HR for a phone interview.  This discussion is a high-level conversation to understand more about your background and interests and for us to share more about Coterie and the position.
  • Phase 2: Selected candidates will then meet our Hiring Manager for the 2nd interview via Teams video. This interview is designed to be more detail oriented and allows you to learn more about the role
  • Phase 3: Top candidates will receive an invite for our final interview series via Teams video. This series will include an experiential exercise project (provided in advance), 1:1 interviews with selected team members and a culture focused interview. The final series is roughly 1.5-3 hours in total but can be scheduled over a few days for flexibility.

What’s in it for you? 
Coterie has excellent benefits for all full-time employees. We offer the following:

  • 100% remote.
  • Health insurance through Aetna (we pay 100% of premiums).
  • Dental and vision insurance through Guardian (we pay 100% of premiums).
  • Basic life insurance (we pay 100% of premiums).
  • Access to flexible spending account (FSA) or health savings account (HSA) (for those using HSA eligible plans).
  • 401K plan (up 4% match with immediate vest).
  • Unlimited PTO and company paid holidays. 
  • Continuing education stipend.
  • A culture with a deep belief in intentionality, inclusion, and treating you like the professional you are.
  • Formalized, universal mentorship via Coterie Core-Coaching program.
  • The salary range for this position is estimated between 53,000-60,000 based on national data. Candidates who meet all the minimum requirements and possess additional relevant experience, as outlined in the job description, may be considered for a salary above the midpoint of the specified salary range.  Salary is based on internal equity; internal salary ranges; market data/ranges; applicant’s skills; prior relevant experience; degrees or certifications, etc. 
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