Claims Support Operations

Description

JOB SUMMARY:

The Claims Support Operations team serves as a critical support function within the claims call center, ensuring adjusters can focus on claim resolution by handling administrative, operational, and customer support tasks. This role supports claim lifecycle activities, improves efficiency, and enhances the overall customer and adjuster experience.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Claim Intake & Setup

Assist with First Notice of Loss (FNOL) processing and claim setup

Verify policy information and ensure accurate data entry into claims systems

Administrative Support

Manage claim documentation, including uploading, indexing, and organizing files

Process incoming correspondence (email, fax, mail) and route appropriately

Prepare standard letters, forms, and claim-related communications

Maintain accurate and up-to-date claim records

Assist in gathering required documentation for claim investigations such as Vehicle Registration Reports, Police Reports and ISO Reports

Communicate with internal departments and vendors to obtain or relay information

Adjuster Support

Handle inbound and outbound calls on behalf of adjusters when appropriate

Schedule inspections, appraisals, and vendor appointments

Follow up on outstanding documentation (police reports, medical records, etc.)

Provide status updates to customers, agents, and third parties

Customer Service

Serve as a point of contact for basic claim inquiries

Deliver timely and professional communication aligned with service standards

Escalate complex or sensitive issues to adjusters or leadership

Operational Efficiency

Support workload balancing and queue management

Monitor task queues and ensure SLAs are met

Identify process improvement opportunities and escalate trends

Compliance & Quality

Ensure adherence to regulatory requirements and company policies

Maintain confidentiality and data security standards

Participate in quality assurance programs and coaching sessions

Key Performance Indicators (KPIs)

Turnaround time for claim setup and administrative tasks

Accuracy and quality of claim documentation

Service Level Agreement (SLA) adherence

Call handling metrics (AHT, FCR where applicable)

Customer satisfaction (CSAT) scores

Adjuster satisfaction / support effectiveness

Requirements

SKILL AND EDUCATIONAL REQUIREMENTS:

High school diploma or equivalent (Associate’s or Bachelor’s preferred)

1–3 years of experience in insurance, claims, or call center environment

Strong data entry and organizational skills

Excellent verbal and written communication skills

Ability to multitask in a fast-paced environment

Preferred Qualifications

Experience supporting claims adjusters or working in FNOL

Familiarity with claims management systems (e.g., CMS, Snapsheet, ISO, Zendesk)

Knowledge of insurance policies and claims processes

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

Working Conditions:

Position may be performed in a traditional office environment or remotely from an approved home office location.

Work is primarily sedentary and requires prolonged periods of sitting while working on a computer.

Frequent and continuous telephone interaction is required using a headset for most of the workday.

Requires the ability to listen attentively, gather facts, and communicate clearly and professionally.

Requires the ability to work efficiently with multiple computer monitors/screens and simultaneously navigate various software applications and databases.

Fast-paced, deadline-driven environment with established productivity and compliance metrics.

Requires strong multitasking skills, work routinely involves analyzing complex information.

Employees must be able to effectively manage stress while maintaining professionalism, accuracy, productivity, and customer service standards.

Overtime, extended hours, or schedule adjustments may be required based on business needs, or departmental demands.

Consistent, reliable, and predictable attendance is essential to achieve individual and departmental performance expectations.

Physical Requirements:

Ability to remain seated for extended periods throughout the workday.

Ability to frequently use hands, fingers, and wrists for continuous typing, keyboarding, data entry, and operation of standard office equipment.

Ability to use a computer, keyboard, mouse, and telephone/headset for prolonged periods during the workday.

Ability to work on multiple screens and process information from various sources while maintaining accuracy and attention to detail.

Sufficient visual acuity to read computer screens, reports, emails, and other business-related materials and maintain prolonged visual focus on computer monitors.

Sufficient hearing ability, with or without reasonable accommodation, to effectively receive and understand telephone conversations.

Ability to communicate clearly, professionally, and effectively in both verbal and written forms.

Ability to maintain sustained concentration and attention to detail while reviewing, analyzing, and documenting complex claim information.

Ability to analyze information, exercise sound judgment, solve problems, and make decisions in a high-volume work environment.

Ability to effectively manage multiple priorities and meet deadlines while maintaining a high level of accuracy and quality.

Ability to perform work under pressure, handle stressful situations, and adapt to changing priorities and business demands.

Ability to meet established productivity standards.

Regular, predictable, and reliable attendance is required to successfully perform the essential functions of the position and achieve performance metrics.