Primary Purpose:Auditing file selection and audit form creation/maintenance.
Conduct quality evaluations, both verbal and written based upon current practices and procedures established within the Claims Call center for new and existing employees.
Work with Management to diagnose data inconsistencies and audit tool functionality problems as well as tool enhancements.Essential Duties and Responsibilities:- The Claims Review Specialist will be responsible for auditing file selection and audit form creation/maintenance.
Conduct quality evaluations, both verbal and written based upon current practices and procedures established within the Claims Call center for new and existing employees.
Work with Management to diagnose data inconsistencies and audit tool functionality problems as well as tool enhancements.Minimum Skills and Competencies:The requirements listed below are representative of the knowledge, skill and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.- High school diploma or general education degree (GED)- Fully bilingual in English and Spanish- Possess experience in the insurance industry or a call-center environment- Basic knowledge in Microsoft Office (Word, Excel, Outlook, PowerPoint)- Possess skills in effective customer service which includes meeting quality standards for services and satisfying internal and external customers- Ability to assume a methodical approach to evaluate situations- Effective organization and time management skills with the ability to work under pressure and adhere to project deadlines- Ability to work in a fast-paced automated production environment- Possess effective verbal and written communication skills- Ability to successfully perform in a high-energy, dynamic and team-orientated environment- Ability to adapt to new situations and learn quickly- Excellent interpersonal skills with the ability to establish a working relationship with individuals at varying levels within the organizationDesired Skills:- Associates Degree, 2-year college degree or in-lieu of degree equivalent education, training and work-related experience- 1+ year of experience in insurance, call centers and/or claims- Possess working knowledge of basic computer hardware, software and database systems- Working knowledge of industry best practices and policies- High degree of initiative, mature judgment, and discretion- Ability to type a minimum of 30 words per minuteIntegon, a Great Place to Work, provides innovative technology and customer support services to major personal lines insurance providers, including Fortune 100 companies rated A+ (Superior), by A.M. Best, for financial strength.