Kenya Gilbert

obtaining first notice of loss reports for non-complex auto and property claims through an Express Claim Center. The individual handles customer questions on process, policies, and next steps, and updates claim information.

• May schedule inspections, send out mitigation vendors or contractors to customer property or set up housing arrangements as needed

• Contacts or receives contact from customer or other claim related third parties to obtain and/or provide necessary file information to comply with quality and process standards

• Receives, screens, and routes incoming telephone calls and other electronic correspondence

• Takes first notice of loss claims, explains the basic claim process, and provides information of a general nature to customers

• Retrieves, prints, and faxes, or mails supporting documentation to vendors or others as directed

• Handles claim files (locates/requests files, files paperwork, reconstructs missing files, moves misfiled documents, sends to other offices, etc.)

Receives, enters, researches, responds to, and tracks in-person, telephone, email, and written citizen inquiries and complaints relating to city services.

• Refers complex or difficult issues to more senior representative or supervisor. • Engage with citizens either by phone or in person to determine details of the inquiry or problem. • Researches, gathers, and enters all pertinent facts pertaining to issues and complaints into a database during requests. • Contacts departments as appropriate to secure information and/or refer issues and complaints for a response. • Reads and applies various documents such as maps, procedures, and regulations to work situations. • Advises departmental personnel, citizens

Handle between 30-50 calls per day

Answer inbound phone calls from customers and provide accurate solutions
- Provide excellent service and product knowledge to customers
- Reduce customer effort in ordering, shipping, and return experiences
- Keep customers informed on the status of their orders and resolve post-order issues
- Act as a liaison between customer, manufacturer, and freight carrier

reviews and processes insurance claims (Wellness, Accident, and Hospital Indemnity) based on information submitted by policy holders; determines the nature and validity of claims by reviewing policy status, patient eligibility, and supporting medical and other documentation

Keys claims data while interpreting coding and medical terminology in relation to diagnoses and procedures; uses multiple core administration databases, systems and subsystems to process and transmit claims for payment or further investigation

Reviews medical chart notes, provider bills, procedure codes, diagnosis codes, charges and medical records in order to determine validity of accident claim; collects needed information, researches diagnoses, procedures, ad eligibility for payment under accident policy Provides prompt customer service to policy holders, providers and other internal company entities regarding claims; documents phone calls in the system and follows-up on issues if needed; contacts insured or other appropriate persons to verify the accuracy and completeness