Claims Customer Experience SpecialistRemote Atlanta, Georgia, United States
Reserv · Centralia, WA
Job description
Claims Customer Experience Specialist Reserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022. We are focused on automating highly manual tasks to tackle long-standing problems in claims and set a new standard for TPAs, insurance technology providers, and adjusters alike. We have ambitious (but attainable!) goals and need people who can work in an evolving environment. If building a leading TPA and the prospect of tackling the long-standing challenges in claims sounds exciting, we can't wait to meet you. As a Customer Experience Specialist at Reserv, you will be an integral part of our dedicated team focused on providing exceptional service to our customers during the insurance claims process. You will handle phone and chat inquiries, provide support, and ensure a smooth and positive experience for all involved parties as they navigate their claims journey. Your expertise in insurance and claims will enable you to deliver exceptional, empathetic assistance. Highly motivated and growth-oriented. You're excited by the prospect of building a tech-driven claims org. Passionate CX professional who cares deeply about the customer and their experience. Empathetic. You exercise empathy and patience towards everyone you interact with. Sense of urgency at all times, balanced with the ability to be detail oriented. Creative. You challenge existing assumptions and find creative solutions to problems. Curious. You want to know the whole story so you can make the right decisions early and be decisive when it counts. Anti-status quo. You don't just wish things were done differently, you action on it. Communicative. You are comfortable with and understand the importance of phone communications throughout the claims process. And did we mention, a sense of humor. We need you to do all the things typical to the role: • Serve as the primary point of contact for customers, providing professional and compassionate assistance throughout the claims process via phone, email, and other communication channels • Anticipate the customer needs and take action to manage the process to full resolution • Provide guidance and information to customers regarding the claims process, taking any additional steps necessary for the prompt and accurate resolution of their claims • Develop and maintain a solid understanding of claim procedures to provide accurate and consistent information to customers • Accurately record and update customer information, claim details, and related documentation in our internal systems, ensuring data integrity and adherence to company protocols • Identify and address customer concerns, complaints, and disputes with empathy and professionalism • Work collaboratively with internal teams to investigate and resolve complex issues, escalating matters when necessary to achieve timely resolutions • Strive to exceed customer expectations by delivering exceptional service, actively listening to customer feedback, and proactively seeking ways to improve the customer experience • Adhere to company policies, procedures, and regulatory requirements, ensuring the privacy and confidentiality of customer information at all times High school diploma or equivalent is needed; bachelor's degree or relevant insurance certifications are a plus Previous experience in customer service or a call center environment, preferably within the insurance industry, with a focus on claims; high volume, fast-paced Strong knowledge of insurance claims processes, terminology, and best practices Excellent communication skills, both verbal and written, with the ability to explain complex concepts clearly and empathetically to customers Active listening skills to understand customer needs, concerns, and emotions, and respond appropriately Strong problem-solving and critical-thinking abilities Proficiency in using customer relationship management (CRM) systems and other relevant software applications Empathy, patience, and resilience to handle challenging customer interactions with professionalism and composure Strong organizational and time management skills to prioritize tasks and meet deadlines effectively Must be able to obtain designated home state claim adjuster license in 60 days Generous health-insurance package with nationwide coverage, vision, & dental 401(k) retirement plan with employer matching Competitive PTO policy we want our employees fresh, healthy, happy, and energized! Generous family leave policy Work from anywhere to facilitate your work life balance Apple laptop, large second monitor, and other quality-of-life equipment you may want. Technology is something that should make your life easier, not harder! At Reserv, we value diversity in backgrounds, perspectives, and life experiences and believe that diversity in viewpoints and critical thinking drives innovation, first-principles thinking, and success. We welcome applicants from all backgrounds and encourage those from all walks of life to apply. If you believe you are a good fit for this role, we would love to hear from you!
More jobs in Centralia, WA
" "" Licensed Clinical Psychologist Wage: Up to $185/hour Licensed Clinical Psychologists — Are you ready to launch or expand your private practice? Headway is here to help you start accepting insurance with ease, increase your earnings with higher rates, and start taking covered clients sooner. It's all on one free-to-use platform, no commitment required. About you ● You're a fully-licensed Clinical Psychologist at a Master's level or above with PSY, PSYP, or PsyD licensure (accepted on a state by state basis), a valid NPI number, and malpractice insurance. ● You're ready to launch a private practice, or grow your existing business by taking insurance. About Headway Your expertise changes lives. Taking insurance makes it accessible to those who need it most. Every mental health provider who goes in-network with Headway supports people who'd otherwise be forced to choose between paying out of pocket, or not getting care at all. We make that process seamless — empowering you to accept insurance with ease, so you can do what you do best. So far, we've helped over 50,000 providers grow their practices, reaching countless people in need. How Headway supports providers - Start taking insurance, stress-free: Get credentialed for free in multiple states in as little as 30 days and start seeing covered clients sooner. - Built-in compliance: Stay compliant from day one with audit support and ongoing resources. - Expansive coverage: Work with the plans that most clients use, including Medicare Advantage and Medicaid. - Increase your earnings: Secure higher rates with top insurance plans through access to our nationwide insurance network. - Dependable payments: Build stability in your practice with predictable bi-weekly payments you can count on. - Built-in EHR features: Manage your practice in one place with real-time scheduling, secure client messaging, end-to-end documentation templates, built-in assessments, and more. - Free continuing education: Nurture your long-term professional goals and earn CEUs with complimentary courses on Headway Academy. How Headway supports your clients ● Increased access: Headway makes it easier for your clients to get the care they need at a price they can afford through insurance. ● Instant verification: Clients can easily check their insurance status and get the care they need without disruption. Please note: At this time, Headway can't support mental health professionals that aren't fully licensed. If your application was rejected for incomplete licensure, you're welcome to reapply once you have a valid license. "" "
Utilization Management Nurse (84124)
Regency Integrated Health Services · Centralia, WA
Utilization Management Nurse RIHS Austin Regional Office - Austin, TX 78727 Overview Position Type Full Time Description Primary Responsibilities The Utilization Management Nurse will determine the medical appropriateness of inpatient and outpatient services by evaluating medical guidelines, benefit determination and compliance with state mandated regulations. Essential Functions • Perform concurrent, retroactive and pre-service authorization reviews for inpatient and outpatient services. • Follow and maintain compliance with CMS requirements, may include after-hours, holiday and weekend coverage. • Collaborate with staff, physicians, care/service coordinators, and medical directors to coordinate and provide the level of care necessary to meet member's health need. Qualifications Location Requirements This position is remote but requires the employee to live within our service area, which can include any of the following areas within Texas: Rio Grande Valley, DFW, greater Austin, greater Houston, greater San Antonio, Coastal Bend, or Laredo. Educational/Training Requirements • Graduate from an Accredited School of Nursing. Bachelor's degree in Nursing preferred. 2+ years of clinical nursing experience. • Payor Utilization Management: 3 years recommended experience • Proficiency with Microsoft Office applications, specifically Word, Excel, and Outlook • Proficiency using Milliman Care Guidelines (MCG) and/ or InterQual criteria. Licensing Requirements • Current unencumbered LVN or RN license in Texas or compact license. Experience Requirements • 2+ years Utilization management experience with a health insurance company (managed care/payer experience required). • UM for Medicare Advantage, Managed Medicaid, Dual SNP Lines of Business, on the payer side. • 5+ years of acute clinical experience. • The ability to effect change, perform critical analyses, promote positive outcomes, and facilitate empowerment for members/families. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk and hear. Specific vision abilities required by this job include close vision, distance vision, and ability to adjust focus. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
No Experience Needed - Remote Customer Service Rep
AO Globe Life · Centralia, WA
Empower Members. Protect Legacies. About Us AO Globe Life has a 70-year legacy of delivering exceptional service and trusted insurance solutions to veterans, labor union members, credit union members, and their families. We pride ourselves on offering expert guidance and support, ensuring our members secure the life insurance and supplemental benefits they need to protect their loved ones and build lasting legacies. We are seeking driven and service-oriented professionals to join our team as Remote Insurance Specialists. This role provides a unique opportunity to make a meaningful impact while benefiting from the flexibility and earning potential of a remote work environment. What We Offer • Fully Remote Position - Enjoy the freedom to work from anywhere. • Six-Figure Earning Potential - Competitive, uncapped commissions. • Exclusive Warm Leads - No cold calling; leads are provided from our extensive membership database. • No Overhead Costs - Focus on what matters most-our members. • Top Performance Incentives - Recognition and rewards for outstanding results. • Union Membership - OPEIU Local 277. • Established Stability - Be part of a 70-year-old organization with a strong commitment to member satisfaction and legendary service. Key Responsibilities • Engage with members through daily calls, leveraging our warm lead database. • Assess financial needs and recommend tailored insurance and supplemental benefits solutions. • Deliver exceptional customer service to ensure member satisfaction and retention. • Guide members through the application process, addressing questions and concerns promptly. • Provide ongoing policy support, including policy reviews, beneficiary updates, and claims assistance. • Maintain compliance with all regulatory and ethical standards in life insurance sales and servicing. Ideal Candidate Profile • Strong communication skills, both written and verbal. • Proficient in organization, time management, and computer-based tools. • Self-motivated, detail-oriented, and driven to exceed sales goals. • Demonstrated sales experience (preferred). • Ability to qualify for a Life Insurance License. • Competitive mindset with excellent problem-solving and critical-thinking skills. • Comfortable working independently and collaboratively in a remote team environment. • Open to feedback, coachable, and eager to implement constructive advice. Eligibility Requirements • Must be a U.S. citizen or legally authorized to work in the United States. • We are currently unable to hire non-U.S. residents. This role offers an exceptional opportunity to combine your passion for helping others with a lucrative, rewarding career. If you're ready to take your skills to the next level and make a lasting difference in the lives of others, we encourage you to apply today.
Artist
Park Candy · Centralia, WA
Freelance Artist Opportunity We're looking for talented freelance artists to collaborate with us on upcoming collections. As a Park Candy artist, your work will be transformed into apparel, accessories, and more — reaching an audience that loves unique, collectible designs. About Park Candy Here at Park Candy, we value each and everyone of our team members. We're looking for folks who are personable, fun, and passionate about bringing quality work and good times to the table. What We're Looking For • Strong artistic style in one or more of the following: • Tiki & Polynesia • Mid-Century Modern • Concept Art • Ability to create artwork that translates seamlessly into vector or high-quality export formats • Strong sense of color, pattern, and storytelling through design • Reliability in communication and meeting project deadlines • Quick turn arounds are loved and appreciated What You'll Do • Collaborate with our team to create artwork for seasonal collections and special releases • Provide original artwork that can be adapted for product design • Compensation structures vary by project — we'll discuss what works for both of us Why Work With Us? • Your art will live on unique, quality products enjoyed by thousands of collectors and fans worldwide • Flexible, remote freelance work • Opportunities to be featured in collaborative launches, special events, and limited-run drops Salary $100 - $2,000 per month