Claims Call Center

Role Summary

Key Responsibilities

• Handle inbound customer calls related to insurance claims, FNOL, claim status, coverage, payments, and settlements .
• Accurately capture and document claim information during the FNOL process.
• Verify policy details, coverage, limits, deductibles, and claim status .
• Explain claims procedures, required documentation, and next steps to customers.
• Provide timely and accurate updates on claim progress.
• Address customer questions and resolve routine claim-related issues during the call.
• Coordinate with claims adjusters, brokers, agents, payment teams, and internal departments to resolve customer queries.
• Follow up on outstanding claim information and documentation when required.
• Identify and escalate complex claims, complaints, coverage issues, or service requests to the appropriate team.
• Maintain accurate customer, claim, and call records in the relevant systems.
• Ensure all interactions are handled within defined SLAs, quality standards, and compliance requirements .
• Handle sensitive customer situations professionally and demonstrate empathy during claim interactions.
• Identify recurring customer issues and provide feedback to improve claims processes and customer experience.
• Follow company policies, regulatory requirements, data privacy guidelines, and claims handling procedures.

Required Skills

• Strong understanding of P&C insurance and claims processes .
• Experience handling customer calls in an insurance/claims environment .
• Strong verbal and written communication skills.
• Excellent customer service and active listening skills.
• Ability to handle difficult or escalated customer interactions professionally.
• Strong problem-solving and decision-making skills.
• Good attention to detail and accurate documentation skills.
• Ability to manage high call volumes and multiple customer requests.
• Ability to work effectively within a team and meet defined SLAs/KPIs.
• Good working knowledge of MS Office and claims/customer service applications .

Key Performance Areas