Claims Associate

Job Description

Job Description

Job Profile

Job Title: Claims Associate

Location: Remote– U.S Based

Hire Type: Contingent

Pay Range: $28/hr.

Work Model: Remote

Work Shift: Monday-Friday 8 am – 4:30 pm

Recruiter Contact: Sean Craft I View email address on ziprecruiter.com I View phone number on ziprecruiter.com

Nature & Scope:

Positional Overview

We are seeking a detail-oriented and customer-focused Claims Associate – Consumer to support the processing and adjudication of consumer claims related to credit card and financial program benefits. The ideal candidate will be bilingual in Brazilian Portuguese and English and possess strong communication, organizational, and analytical skills. This role is responsible for processing claims efficiently, making coverage determinations, handling customer inquiries, and ensuring exceptional service delivery in a fast-paced remote environment.

Role & Responsibility:

Tasks That Will Lead to Your Success

• Process first-party property and consumer claims in accordance with client-specific program guidelines and coverage requirements.
• Investigate claims and evaluate documentation to determine benefit eligibility and claim outcomes.
• Adjudicate settlements or denials within designated authority levels.
• Handle a high volume of claims, phone calls, emails, and correspondence while maintaining accuracy and professionalism.
• Ensure claim files are properly documented and updated within the claims management system.
• Maintain compliance with production goals, quality standards, customer guidelines, and deadlines.
• Communicate effectively with customers, clients, and internal teams regarding claim status and required documentation.
• Assist with administrative and operational tasks as assigned.
• Support organizational quality initiatives and continuous improvement efforts.

Skills & Experience

Qualifications That Will Help You Thrive

• High school diploma or GED required.
• One (1) year of general office, customer service, or claims-related experience required.
• Claims industry experience preferred.
• Must be bilingual in Brazilian Portuguese and English (required and must be listed on resume).
• Licensing experience or willingness to obtain appropriate licenses preferred.
• Knowledge of first-party property and casualty claims adjudication preferred.
• Strong verbal and written communication skills.
• Proficiency with Microsoft Office products and general computer applications.
• Excellent organizational and multitasking abilities.
• Analytical and problem-solving skills with strong attention to detail.
• Ability to work independently and collaboratively in a team environment.
• Ability to meet or exceed performance and productivity expectations.
• Strong customer service orientation and professionalism in a remote work setting.