Bilingual Auto Repair Customer Service Representative (Jr. Protection Claims Adjuster)

At this time, a Bilingual Auto Repair Customer Service Representative (Jr. Protection Claims Adjuster) is needed to provide support to our Protection Claims Adjusters and handle a large volume of Protection claim calls, which includes providing claim statuses, communicating processes, sending claim forms/procedure sheets, and notices, updating claim status notes. Processing/distributing incoming and outgoing claim documents, opening/adjudicating new claims, and responding to emails which includes managing general claims email boxes. Perform related functions as assigned.

Work Schedule:
Monday through Friday, 8:30 a.m. to 5:00 p.m. PST

Work Arrangement:
The Jr. Protection Claims Adjuster position follows a hybrid work schedule. Employees will work from home on Tuesday, Thursday, and Friday, and onsite at the Strongsville, Ohio office on Monday and Wednesday.

Training Requirements:
Initial training will be conducted onsite at the Strongsville, Ohio office, Monday through Thursday.

Essential Functions:

Customer Service & Claims Adjudication:

• Strive to uphold Core Values of Serving People, Building Trust, Improving Continuously, and Embracing Innovation & Change.
• Return after-hours voicemail messages and/or distribute them to their intended recipients, first thing every morning and timely during business hours if messages are received.
• Distribute and sort incoming claims e-faxes, locate corresponding claims, and place e-faxes into the pending documents sections.
• Respond to emails from the general claims inbox, locate corresponding claims, and place files into pending document sections when applicable.
• Notify management if any escalated attorney, department of insurance, or equivalent files are received.
• Open all incoming claims mail, locate corresponding claims, scan/save onto shared drive, place the file into the pending documents sections, and maintain file retention policies.
• Answer incoming claims calls, identify key information about the customer’s contract, and answer questions related to coverage.
• Place outbound claims calls and communicate follow-up information as needed.
• Communicate new claims instructions and/or provide claim forms.
• Review incoming claim documents assigned to you and/or your teammates.
• Review and respond to incoming emails and text messages within the same business date of receipt with a target of 1-business hour from receipt.
• Gather any additional information needed, such as pictures or ordering inspections, prior to authorizing claims.
• Ensure 100% of all authorized claims are approved by the appropriate parties, prior to authorization.
• Adjudicate claims, in accordance with the applicable agreement terms and state requirements and provide authorization within 1 business hour of receipt if no additional information is required.
• Ensure all claim handling and communication are handled within our desired metrics.
• Provide simple claims web navigation support.
• Maintain professional and technical knowledge.
• Work independently & proactively.
• Assist the Protection Claims Supervisor with various projects.

Processing Claim Payments/Reimbursements:

• Accurately calculate claim payments in accordance with the applicable agreement terms and state requirements.
• Upon receipt of final invoices/repair orders, verify all required information has been provided, verify the name, and address of the payee, and enter payments into our operating system.
• Utilize and Promote US Bank Credit Card for most claims’ reimbursements.

Claims Quality Control:

• Maintain a minimum score of Job Well Done on the monthly Key Objectives, which includes the following screening: file audits, calls, new claim handling, attendance, and actively participating in monthly 1-on-1s and coaching and development plans.

Be a Team Player with Other Departments:

• Support other teams.
• Cross-train to gain basic knowledge of other departments within our organization.
• Share ideas that may help with organizational productivity.

Required Knowledge, Skills, and Abilities:

• Reliable and punctual
• Keeps a positive attitude and remains cool under stress
• Plan, organize, prioritize, and complete projects and assignments in a timely manner
• Detail-