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

Training Requirements

Initial training will be conducted onsite at the Lake Forest, CA 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-oriented, accurate, and highly organized
• Displays pride in work
• Active listener with the ability to adapt/respond to various types of personalities
• Receptive to coaching and development
• Interact effectively with associates, management, and internal and external customers
• Superior communication skills, both written and verbal
• Demonstrate that you can solve customer problems using creative and effective techniques
• Maintain confidentiality of sensitive company information and use judgment and tact in applying policies, solving problems, and communicating standards
• Operate computer hardware and software, including Microsoft Office Suite, and specialized software applications
• Ability to type at least 40 wpm + Strong 10-key
• Strong mathematical aptitude
• Operate a calculator and related office equipment
• Proven ability to multi-task and handle interruptions
• Ability to work flexible hours

Required Education and Experience

• Bachelor’s degree or equivalent work experience (see below)
• Bilingual in English/Spanish
• 2+ years of clerical/administrative experience
• 2+ years of customer service experience
• 2+ years of call center experience

Preferred Skills

• Knowledge and experience within the automotive or insurance industry

Work Environment and Physical Requirements

• Vision acuity is required to include close vision, color vision, distant vision, and the ability to adjust focus.
• Ability to grasp objects such as a telephone or computer mouse, finger dexterity to use a keyboard, calculator, and standard office equipment
• Ability to walk, stand, reach with hands and arms; stoop kneel, crouch, and lift up to 25 pounds.
• Ability to frequently sit for long periods of time.…