What are the responsibilities and job description for the Claims Processor I position at Builders Mutual?
At Builders Mutual, we believe in the power of a team to get the job done right.
Our team does their best work each day, creating a one-stop resource for all commercial insurance solutions and construction safety resources, leading to powerful results. Our culture elements of teamwork, inclusion, expertise, and community aren't just words on a page—it's integral to who we are, how we work, and what sets us apart. We live out our values every day, striving to serve better and achieve more.
The OPPORTUNITY
Leverage your claims experience and join our team as a Claims Processor I! This role will receive cross-functional training in various claims support tasks such as: cataloguing incoming electronic documents for the entire claims department, preparing and sending daily, weekly, monthly claims reports. This role will respond to inbound calls with the goal of providing an exceptional customer experience. Because the success of our company is rooted in teamwork, the way we care about the people we work with and serve, this hybrid role will work in our Raleigh office two days a week with the flexibility to work from home the remaining three days.
Your WORK as a Claims Processor will make a difference as you:
- Adhere to the Claims Support schedule to ensure call service levels are met and customer satisfaction remains high.
- Index documents accurately and consistently attain monthly goal.
- Prepare reports and letters, completing and submitting them on time based on jurisdictional requirements.
- Initiate offsite check printing and prepare EOB's daily.
- Respond to inbound calls from both internal and external customers and handle appropriately in a timely manner.
- Process unidentified mail, agent mailings and underwriting return envelopes to proper resolution.
- Investigate provider inquiries regarding bills and payments, providing EOBs as requested.
- Report any challenges, defects with workflows to Claims Support Supervisor
- Demonstrate proficiency with systems (ImageRight, Advanced Claims, phone system).
- Issues payments for claims file expenses as directed.
- Process Entity Entry (I-9) to ensure compliance.
- Assist in training team members.
- Photocopying claim files, cataloguing medical records and electronic claim file data including EDI and other similar items.
- Performs data entry functions as directed by Adjusters and Claim Services Manager
Skills to get the JOB done RIGHT:
- High school diploma or equivalent
- At least 2 years of customer service/support experience and/or two years of commercial insurance and/or claims experience or an equivalent combination of education and experience.
- PC Computer skills (MS Office, Outlook); knowledge of policy processing systems, imaging systems and/or CRM systems is a plus.
- Excellent customer relationship management skills required.
- Ability to learn quickly and adapt to changing environment.
- Solid customer focus and soft skills
WHY YOU’LL LOVE TO WORK HERE
Builders Mutual cares about you, and we offer comprehensive employee benefits built to support your success and wellbeing, including:
- Market-driven compensation and bonus plan
- 3 weeks of paid time off (and your birthday too!)
- 37.5-hour work week; end your Friday at 2:30PM
- Builders University for employees, dedicated to supporting development and enhancing expertise
- Earn swag and extra time off through peer recognition Builders Bucks program
LIFE at Builders Mutual
- Collaboration | You are part of a team working together to reach a common goal.
- Empowerment | You will feel trusted, valued and be given the resources to be successful.
- Flexibility | You will be part of a dynamic work environment designed to allow you to do your best work while also creating the best possible customer experience.
- Impact | You will positively influence our business, customers, and industry.
- Sense of pride | You will tell others how much you enjoy working at Builders Mutual.
