Hybrid Customer Service Representative

About the role

Join our dynamic team as a Hybrid Customer Service Representative specializing in insurance claims. You will work both on‑site and remotely, handling end‑to‑end claim processing while delivering empathetic support to customers across phone, email, and digital channels.

Key responsibilities

• Process insurance claims from intake to settlement, ensuring coverage validation, liability assessment, and payment decisions comply with internal policies and external regulations.
• Interact with customers to explain claim status, required documentation, and next steps, maintaining a calm and solution‑focused approach.
• Review claim documents, policy schedules, loss descriptions, and supporting evidence to identify missing information, inconsistencies, or red flags.
• Coordinate with underwriting, policy servicing, and quality teams to clarify complex policy terms, endorsements, and exclusions.
• Apply structured problem‑solving to evaluate alternatives and select appropriate settlement options.
• Use claim administration tools and customer service platforms to log interactions, update notes, and track service‑level metrics.
• Escalate complex or high‑value claims according to SOPs, escalation matrices, and approval thresholds.
• Maintain strict compliance with information security, confidentiality, and data‑privacy standards.
• Monitor personal performance metrics (AHT, FCR, claim accuracy, CSAT) and take proactive actions to meet targets.

Required profile

• 2‑4 years of hands‑on experience in insurance operations, claims processing, or a related customer‑service environment.
• Ability to work in a hybrid model with rotational shifts, maintaining reliable connectivity.
• Strong communication skills with a patient, clear, and solution‑oriented approach.

Required skills

• Microsoft Excel