Sign up to access all features of our service.
  • Job search
  • Favorites
  • Create a CV
    New
  • Salaries
  • Subscriptions

Tier II Claims Resolution Representative - 12pm - 8pm

Koozie Group

Customer Support Claims Tier II

Do you have a passion for excellence? Are you a natural problem solver who loves to deep dive and find the root cause of an issue? Are you someone who looks around corners anticipating the next steps to avoid delays and hurdles?

If you answered yes to any of the above questions…we want you!

Our Omni Channel Support Specialist team is Customer Obsessed and strives to provide a world class experience with each and every customer interaction. We interact with our customers through many channels, including email, telephone, text and chat and are looking for folks who understand how to make personal connections with our customers and help ensure their orders are processed properly, on time and with a smile!

Our ideal Omni Channel Support Specialist candidate is awesome at the following:

  • Demonstrate the ability to think quickly and deliver results
  • Demonstrate active listening, critical thinking and problem-solving skills
  • Ability to move quickly through multiple systems to find information and deliver a response based on findings
  • Demonstrate empathy to customers, deescalate issues with care and compassion, and maintain a professional attitude at all times
  • Deliver all communications with kindness, verbal, email, chat and other – we strive to make every interaction positive and productive
  • Be process oriented, understanding the value of standard work and consistency
  • Always act with Integrity and take personal ownership of all you do
  • Champion change and adapt quickly and positively in a dynamic workplace

As part of our team, you will:

  • Research/Investigation -Research current systems and other related items to identify the cause
  • Adjustments -issue credits/discounts and accurately enter information into order management system.
  • Assist in managing daily claims workflow for decorated product issues, including misprints, order errors, product defects, shipment delays, and damaged goods.
  • Answering incoming calls and inquiries from our customers, sales and account management to resolve customer questions and concerns
  • Researching customer inquiries utilizing company resources and document customer conversations, information, questions, corrective action/answers, and product orders in the tracking application
  • Resolving roadblocks by researching and working with other departments. Follow through on issues by placing outgoing calls to retrieve additional information or returning calls to offer information regarding resolution
  • Acting as a liaison between client and various departments
  • Assist in ensuring claims are processed within service-level standards, maintaining a balance between customer satisfaction and company policy.
  • Participating in meeting team goals for service, quality and cost
  • Participating in and support company-wide initiatives such as continuous operational improvement in order to improve service, reduce costs, and improve quality
  • Mentor, advise and lead your team members in their journey to customer excellence.
  • Lead by example, handling customer escalations with creative problem-solving.
  • Raise the Bar with each and every customer interaction, delivering an amazing customer experience utilizing service excellence techniques
  • Consistently and respectfully Raise the Bar by identifying trends in customer concerns and escalating properly to leadership
  • Take responsibility to develop a deep knowledge of our product portfolio and a working knowledge of Operations business processes including order flows, manufacturing and shipping.
  • Able to identify and drive process improvements or make recommendations that improve the overall customer experience.
  • Support special projects, system enhancements and cross-department initiatives related to claims management
  • Other duties as required

Minimum Qualifications:

  • High School Diploma or Equivalent
  • 2 - 4 years customer service/support experience
  • Tech savvy with the ability to communicate using multiple channels; chat, text, email
  • Proficiency using Microsoft Office Suite, specifically Outlook, Word & Excel
  • Excellent communication, conflict resolution, and problem-solving skills
  • Willingness and ability to work remotely

Preferred Qualifications:

  • Experience using order management systems such as Oracle & Salesforce
  • Call Center Experience

Our customers come from all walks of life and so do we. We hire great people from a wide variety of backgrounds, not just because it's the right thing to do, but because it makes our company stronger. If you share our values and our enthusiasm to Keep the Good Going, you will find your way at Koozie Group. Koozie Group is proud to be an Equal Opportunity Employer. We do not discriminate against any applicant or employee based on race, age, sex (including pregnancy, childbirth, or related medical conditions), gender, marital status, national origin, ancestry, citizenship status, mental or physical disability, religion, creed, color, sexual orientation, gender identity or expression (including transgender status), veteran status, genetic information, or any other characteristic protected by applicable federal, state or local law. Koozie Group also prohibits harassment of applicants and employees based on any of these protected categories. In compliance with the Americans with Disabilities Act, Koozie Group will provide reasonable accommodations to qualified individuals with disabilities and encourages both prospective and current employees to discuss potential accommodations with the employer

Vacancy posted 2 days ago
Similar jobs that could be interesting for youBased on the Tier II Claims Resolution Representative - 12pm - 8pm in United States vacancy
  •  ...Customer Support Claims Tier II Do you have a passion for excellence? Are you a natural problem solver who loves to deep dive and find...  ...information or returning calls to offer information regarding resolution Acting as a liaison between client and various departments... 
    Suggested
    Work at office
    Local area
    Remote work

    Koozie Group

    Clearwater Beach, FL
    17 hours ago
  •  ...customer service experience, and proficiency in Microsoft Office Suite. This role involves problem-solving, research, and assisting in claims management while ensuring high customer satisfaction. A people-first culture and robust training are offered for all positions. #J-... 
    Suggested
    Work at office

    Koozie Group

    Spring Hill, FL
    1 day ago
  •  ...Wolfson Children's Hospital.Baptist Health is hiring a Claims Resolution Specialist II for our Hospital Billing Team department. This is a full...  ...from paying entities.Communicates with third-party representatives as necessary to complete claims processing and /or resolve... 
    Suggested
    Full time
    Work at office

    Baptist Health System, Inc.

    Jacksonville, FL
    4 days ago
  •  ...Customer Support Tier II If our name sounds familiar, there's a reason why. We're the...  ...returning calls to offer information regarding resolution Meeting individual customer service...  ...with other customer service claim teams Responding to client inquiries... 
    Suggested
    Work at office
    Local area
    Remote work

    Koozie Group

    United States
    1 day ago
  • $100 per hour

    Claims Representative II - Auto Adjuster - (Hybrid) - Remote | WFH job at Get It - Executive. Indianapolis, IN. Are you a skilled claims professional...  ...You'll play a key role in ensuring fair and timely claim resolutions while providing excellent service to policyholders and... 
    Suggested
    Remote job
    Full time
    Temporary work
    Work at office
    Work from home
    Flexible hours

    Get It - Executive

    Indianapolis, IN
    3 days ago
  • Join to apply for the Michigan Homeowners Claim Representative II role at AAA-The Auto Club Group . Get AI-powered advice on this job and more...  ..., taking statements, and establishing evaluation and resolution plans for claims. Responsibilities include reviewing claims... 
    Full time
    Work at office
    Flexible hours

    AAA-The Auto Club Group

    Auburn Hills, MI
    4 days ago
  • Markel Service Inc. in Omaha, Nebraska is seeking a Claims Adjuster responsible for the resolution of moderate complexity Workers Compensation claims. The role requires a bachelor's degree and eligibility for a claims adjuster license. The ideal candidate has 2-3 years... 

    Markel Service Inc.

    Omaha, NE
    2 days ago
  • $60k - $71.05k

    Claims Analyst II page is loaded## Claims Analyst IIlocations: 8215 Greenway Boulevard - MIDDLETON...  ...cutting-edge technology and top-tier human support together, we connect clients...  ...handling claims from assignment through resolution, ensuring timely, accurate, and compliant... 
    Work at office
    Immediate start
    Flexible hours

    Acrisure, LLC

    Springfield, IL
    17 hours ago
  • $55.3k - $92.6k

     ...Join to apply for the Claim Representative II Remote role at Emergent Holdings . Job Description This is the intermediate level of the claim...  ...service skills. Negotiation, consensus-building, and conflict resolution abilities. Ability to manage multiple priorities and meet... 
    Full time
    Contract work
    Work at office
    Local area
    Remote work

    Emergent Holdings

    New York, NY
    3 days ago
  • $56.7k - $94.9k

     ...Claim Representative This is the entry level professional claim handler. Handles medical only and...  ...Concludes and closes files following resolution of claims to meet internal performance...  ...years of AF Group Claims Representative II experience that includes discretion in... 
    Contract work
    Traineeship
    Work at office

    Emergent Holdings

    Encino, CA
    12 days ago
  • $70k - $85k

     ...Overview Position Title: Workers' Compensation Claim Representative II Location: Maitland, FL (hybrid preferred, remote considered)...  ...claim investigations, compensability decisions, and timely resolution strategies. This role provides an excellent opportunity to... 
    Work at office
    Remote work

    CCMSI

    Maitland, FL
    3 days ago
  • $59.13k - $69k

     ...Full time Exempt/Non Exempt: Salary Job Description: APD Claim Representative II (Florida) - The Auto Club Group Reports to: APD Claim Manager...  ..., take statements and establish clear evaluation and resolution plans for claims. In this position, you will have the opportunity... 
    Full time
    Temporary work
    Work experience placement
    Remote work
    Work from home
    Relocation
    Home office
    Flexible hours
    Night shift
    Weekend work
    Afternoon shift

    AAA-The Auto Club Group

    Florida
    1 day ago
  •  ...Call Center Representative Location: Washington, DC Duration: Long Term Work duties...  ...level troubleshooting support, problem resolution and walk the user through a series of steps...  ...GOTS products. Escalate tickets to Tier II/Tier III Technicians if an incident or... 
    Work at office
    Remote work
    Weekend work

    E-talentnetwork

    United States
    2 days ago
  • $70k - $85k

    Overview Position Title: Workers' Compensation Claim Representative II Location: Maitland, FL (hybrid preferred, remote considered) Schedule...  ...claim investigations, compensability decisions, and timely resolution strategies. This role provides an excellent opportunity to... 
    Work at office
    Remote work

    Cannon Cochran Management Services, Inc.

    Florida, NY
    1 day ago
  •  ...DigitalOptometrics, a growing company in the telehealth field, seeks a Desktop Support/Customer Service Technician - Tier II to join out Lake Success, New York office. This is a fully onsite position in which you will be working a mixed role providing both technical... 
    Work at office
    Remote work

    DigitalOptometrics

    New Hyde Park, NY
    20 days ago
  • $250k

     ...will be responsible for the resolution of moderate complexity and moderate...  ...Workers Compensation claims in multiple jurisdictions. The...  ...high level of production. Represents Markel in mediations, as required...  ...for the Claims Examiner II is $62,400 - $85,800 with 12%... 
    Full time
    Work experience placement
    Work at office
    Local area
    Remote work
    Work from home

    Markel

    Richmond, VA
    4 days ago
  •  ...and other common practices across the system. Position Summary The Epic Hospital Billing Claims and Remittance Analyst II is responsible for supporting and optimizing Epic’s Resolute Hospital Billing (HB) module, focusing on claims processing and remittance workflows.... 
    Work at office
    Remote work

    Hartford Healthcare

    Hartford, CT
    1 day ago
  • $59.9k - $98.2k

     ...Claims Specialist II - Workers Compensation 132811 At Zurich North America Claims we acknowledge that work life-balance and flexibility...  ...the loss falls within the coverage. Work to have a timely resolution to claims by developing case strategy; developing a case... 
    Full time
    Temporary work
    For contractors
    Apprenticeship
    Work at office
    Local area
    Remote work
    Visa sponsorship

    Zurich NA

    Schaumburg, IL
    3 days ago
  •  ...Lost Time Claims Specialist Ii UPMC WorkPartners is hiring a full-time Lost Time Claims Specialist II! This role will predominantly work...  ...direction of supervisor. # Pro-actively manages the case resolution process. May participate in mediations within limit of settlement... 
    Full time
    Remote work
    Monday to Friday

    UPMC

    United States
    2 days ago
  • $90k

     ...Job Description CGL Claims Examiner II Job Summary Seeking a highly skilled and motivated CGL Claims Examiner II to join a...  ...inception to closure, including investigation, evaluation, and resolution of claims. Document all claim file activity, including... 
    Local area
    Flexible hours

    The Jonus Group

    Scottsdale, AZ
    17 hours ago
  • $116k - $162k

     ...Claims Specialist II Everest Insurance Company is seeking an experienced claims professional or attorney to join the Casualty Claims team...  ...Developing and executing claim strategies as well as resolution strategies Negotiating and resolving cases Attending... 
    Full time
    Immediate start

    Everest

    Warren, NJ
    2 days ago
  • $34k - $39.5k

     ...Innova Solutions is immediately hiring for a Claim Analyst II. Position type: Permanent Duration: Fulltime Location: Remote As...  ...Enterprises (MBEs) in the United States (NMSDC, 2024) AWS Advanced Tier Services Partner with 100+ certifications Website :... 
    Permanent employment
    Full time
    Temporary work
    Work experience placement
    Immediate start
    Remote work
    Worldwide
    Flexible hours

    Innova Solutions

    Saint Louis, MO
    3 days ago
  • $59.9k - $98.2k

     ...At Zurich North America Claims we acknowledge that work life-balance and flexibility are...  ...North America is hiring an Claims Specialist II to join our Workers Compensation team! We...  ...the coverage. Work to have a timely resolution to claims by developing case strategy;... 
    Full time
    Temporary work
    For contractors
    Apprenticeship
    Work at office
    Local area
    Remote work
    Visa sponsorship

    Zurich Insurance Group

    Schaumburg, IL
    2 days ago
  •  ...place for you. Company URL: Responsibilities The Claims Analyst II is responsible for managing high-exposure Workers...  ...explore potential exposures Lead evaluation, mitigation and resolution of WC claims by collaboration with MEC Medical Management Consultants... 

    W. R. Berkley

    Chesterfield, MO
    4 days ago
  • $116k - $162k

     ...Title: Claims Specialist II Company: Everest Insurance Company Job Category: Claims Job Description: About Everest:...  ...Developing and executing claim strategies as well as resolution strategies Negotiating and resolving cases Attending... 
    Full time
    Immediate start

    Everest Insurance®

    Warren, NJ
    3 days ago
  •  ...Claims Resolution Specialist At the Innovative Hematology (IHI), we offer a future where people...  ...of revenue cycle operations. Level II Investigate, analyze, and...  ...Communicate effectively with payer representatives to advocate for reconsideration and drive... 
    Remote work

    Innovative Hematology

    United States
    2 days ago
  •  ...Job Information Job Title Claims Representative II- General Liability (Bodily Injury focused) Home Department: Claims Employment Status: Exempt; Full-time Schedule: 40 hours/week with Flexible Scheduling Opportunities Position... 
    Full time
    Local area
    Remote work
    Home office
    Flexible hours

    Society Insurance

    North Fond Du Lac, WI
    4 days ago
  • $21.4 - $26.74 per hour

     ...Claims Examiner II Location: Bakersfield, CA. (Onsite) Classification: Full-Time This position is non-exempt and will be paid on...  ...providers, Health Plans, and applicable staff, as needed for claim resolution. Maintain compliance with established production and... 
    Hourly pay
    Full time
    Work at office
    Monday to Friday

    Universal Healthcare MSO, LLC

    Bakersfield, CA
    2 days ago
  • $59.9k - $98.2k

     ...Claims Specialist II - Workers Compensation At Zurich North America Claims we acknowledge that work life-balance and flexibility are a...  ...the loss falls within the coverage. Work to have a timely resolution to claims by developing case strategy; developing a case evaluation... 
    Full time
    Temporary work
    For contractors
    Apprenticeship
    Work at office
    Local area
    Remote work
    Visa sponsorship

    Zurich Insurance Company Ltd

    Schaumburg, IL
    2 days ago
  •  ...outstanding leaders and teammates. Position Summary The Underwriter II – Commercial Lines is responsible for providing high-level...  ...agent inquiries via phone and email, with attention to detail and resolution follow-through. Manage workflow from tasks indexed via email and... 
    Temporary work
    Immediate start
    Remote work
    Flexible hours

    PEAK6 Investments

    New York, NY
    3 days ago

Do you want to receive more vacancies?

Subscribe and receive similar vacancies to Tier II Claims Resolution Representative - 12pm - 8pm. Be the first to apply!