Customer Service Operations Associate

Piper Companies is looking for an Operations Associate to join an established Insurance company located in Durham, North Carolina for a HYBRID full-time opportunity.

Responsibilities of the Operations Associate:

• Evaluate claim coverage, verify accuracy, and determine settlement outcomes in compliance with policy provisions and state regulations.
• Investigate claims by contacting claimants, medical professionals, or employers to gather required information and documentation.
• Maintain claim files, input payment details, establish reserves, and document case notes accurately in system databases.
• Collaborate with legal counsel on litigated claims and report irregularities such as overpayments or underpayments.
• Adhere to quality, production, and compliance standards while identifying process improvement opportunities.
  
  

Qualifications for the Operations Associate:

• Bachelor’s degree or equivalent experience in claims processing, insurance, or a related field.
• Strong organizational skills with the ability to manage multiple tasks in a fast-paced environment.
• Excellent verbal and written communication skills, with the ability to navigate sensitive conversations empathetically.
• Knowledge of state regulations, business rules, and tax implications related to claims settlements.
• Proficiency in using claims management software and maintaining accurate records.
• Demonstrated ability to work collaboratively within a team and adapt to varying personality types.
• Commitment to compliance with HIPAA and corporate policies, ensuring confidentiality of claimant information.
• Proven problem-solving skills and attention to detail in evaluating and resolving complex claims.
  
  

Compensation for the Operations Associate:

• Hourly Pay Rate: $23/ hour
• Hybrid work schedule
• Comprehensive Benefits: Medical, Dental, Vision, 401K, PTO, Sick Leave if required by law, and Holidays
  
  

Keywords: Customer Service, HIPPA, CRM, Cross functional collaboration, call center, communication, insurance, claims coverage, reporting, life insurance, annuity claims

This job opens for applications on January 29th, 2025. Applications for this job will be accepted for at least 30 days from the posting date.

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