Hybrid Customer Service Representative – Insurance Claims

About the role

Join our dynamic team as a Hybrid Customer Service Representative focused on insurance claims. You will use your expertise in MS Excel and claim administration tools to streamline processes, ensure compliance, and deliver exceptional service to our customers.

Key responsibilities

• Process end‑to‑end insurance claims within agreed timelines, validating coverage, assessing liability, and making accurate payment decisions.
• Interact with customers via phone, email, or digital channels, explaining claim status, required documentation, and next steps.
• Review claim documents, policy schedules, 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 alternative resolutions and select appropriate settlement approaches.
• Use claim administration 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 related customer‑service environments.
• Ability to work in a hybrid model with rotational shifts, balancing office collaboration days and remote work.
• Strong customer‑service orientation with clear, solution‑focused communication.

Required skills

• MS Excel