137,922 Claims Specialists jobs in the United States

Job Description:

Job Summary:

As a Claims Customer Service Representative, your positive can-do attitude is what makes you an asset. As a representative of Hallmark, you're the voice of the organization and may be the first interaction many of our
callers have with us. Using your superior customer service skills, you'll assist our insured customers and agents with the reporting of a claim and other claim related claim questions and concerns. In this role, you may also complete claim processing functions for new and existing claims, answer emails, or assist agents and customers.

Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience
High school diploma or GED required, with some college or 1-3 years of related experience, personal lines and/or commercial insurance experience preferred.

Knowledge/Skills

• Commercial Auto and Property FNOL experience a plus
• Bilingual Spanish preferred but not required. Advanced phone and verbal communication skills
• Excellent written communication skills
• Must be able to understand basic insurance principles and policy contracts
• Excellent reading skills: must be able to read and follow a script
• Must be customer service oriented, highly organized and efficient
• Property & Casualty insurance industry experience a plus
• Ability to multi-task in a high-volume call center environment
• Customer Service or call center background with professional telephone etiquette preferred
• Typing skills- 35 WPM
• Computer Skills- Advanced skills including working knowledge of Excel, Word and Outlook

Hallmark Financial Services is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Responsible for responding to customer inquiries. Inquiries may be non-routine and require deviation from standard screens, scripts, and procedures. Performs research as needed to resolve inquiries. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures.

45% Ensures effective customer relations by responding accurately, timely, and courteously to telephone, written, web, or walk-in inquiries. Handles situations which may require adaptation of response or extensive research. Identifies incorrectly processed claims and processes adjustments and reprocessing actions according to department guidelines.

45% Examines and processes claims and/or non-medical appeals according to business/contract regulations, internal standards and examining guidelines. Enters claims into the claim system after verification of correct coding of procedures and diagnosis codes. Ensures claims are processing according to established quality and production standards.

10% Identifies complaints and inquiries of a complex level that cannot be resolved following desk procedures and guidelines and refers these to a lead or manager for resolution. Identifies and reports potential fraud and abuse situations.

Additional Skills & Qualifications Required Education: High School Diploma or equivalent. Required Work Experience: 2 years of customer service experience including 1 year claims or appeals processing OR Bachelor's Degree in lieu of work experience. Experience Level Entry Level.

Pay and Benefits The pay range for this position is $17.66 - $17.66/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type This is a fully onsite position in Columbia, SC. Application Deadline This position is anticipated to close on Sep 25, 2025.

Job Description:

Job Summary:

As a Claims Customer Service Representative, your positive can-do attitude is what makes you an asset. As a representative of Hallmark, you're the voice of the organization and may be the first interaction many of our
callers have with us. Using your superior customer service skills, you'll assist our insured customers and agents with the reporting of a claim and other claim related claim questions and concerns. In this role, you may also complete claim processing functions for new and existing claims, answer emails, or assist agents and customers.

Qualifications
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience
High school diploma or GED required, with some college or 1-3 years of related experience, personal lines and/or commercial insurance experience preferred.

Knowledge/Skills

• Commercial Auto and Property FNOL experience a plus
• Bilingual Spanish preferred but not required. Advanced phone and verbal communication skills
• Excellent written communication skills
• Must be able to understand basic insurance principles and policy contracts
• Excellent reading skills: must be able to read and follow a script
• Must be customer service oriented, highly organized and efficient
• Property & Casualty insurance industry experience a plus
• Ability to multi-task in a high-volume call center environment
• Customer Service or call center background with professional telephone etiquette preferred
• Typing skills- 35 WPM
• Computer Skills- Advanced skills including working knowledge of Excel, Word and Outlook

Hallmark Financial Services is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

As a Claims Customer Service Representative, your positive can-do attitude is what makes you an asset. As a representative of Hallmark, you're the voice of the organization and may be the first interaction many of our callers have with us. Using your superior customer service skills, you'll assist our insured customers and agents with the reporting of a claim and other claim related claim questions and concerns. In this role, you may also complete claim processing functions for new and existing claims, answer emails, or assist agents and customers.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

High school diploma or GED required, with some college or 1-3 years of related experience, personal lines and/or commercial insurance experience preferred.

Commercial Auto and Property FNOL experience a plus

Bilingual Spanish preferred but not required. Advanced phone and verbal communication skills

Excellent written communication skills

Must be able to understand basic insurance principles and policy contracts

Excellent reading skills: must be able to read and follow a script

Must be customer service oriented, highly organized and efficient

Property & Casualty insurance industry experience a plus

Ability to multi-task in a high-volume call center environment

Customer Service or call center background with professional telephone etiquette preferred

Typing skills- 35 WPM

Computer Skills- Advanced skills including working knowledge of Excel, Word and Outlook

Hallmark Financial Services is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Required: 1. High school graduate or equivalent. 2. Detail oriented with good problem solving skills. 3. Ability to prioritize and meet deadlines. 4. Proficient in basic math skills. 5. Proficient in Microsoft Office products. Desired: 1. Two (2) years experience in a call center environment. Requirements: 1. Claims and/or calls workload management.

• Work cross-functionally with policyholders, adjusters, and contractors to manage restoration claims effectively. • Serve as the primary point of contact, ensuring clear and timely communication.
• Evaluate claims to determine the most appropriate general contractor assignment.
• Receive and review incoming claims for completeness, accuracy, and validation of loss details, including affected areas and supporting documentation.
• Enter and update policyholder and adjuster details in Salesforce, ensuring accurate tracking and status updates.
• Organize and maintain digital claim files, including policyholder agreements, Certificates of Completion (COC), invoices, payment collections and others as required.
• Schedule and coordinate claim milestones, ensuring deadlines and key performance indicators (KPIs) are met.
• Utilize industry portals and systems to identify and assign qualified general contractors based on geographic area and claim specifics.
• Collaborate with the contractor sales team to proactively source and onboard new general contractors when necessary to ensure timely claim resolution.
• Review claim estimates and quotes to ensure they align with customer needs before submission to adjusters.
• Identify and escalate discrepancies or red flag claims to the Department Head.
• Ensure claims data entry and processing adhere to internal standards and compliance regulations.
• Maintain comprehensive logs of all claim-related communications and activities.
• Conduct self-audits to verify data accuracy and proactively correct any discrepancies.
• Update customer contact preferences to align with communication and estimating guidelines.
• Performs other related duties as necessary or assigned.

• Strong ability to build rapport and trust with new contacts.
• Exceptional customer service skills.
• Demonstrated verbal and written communication skills.
• Strong work ethic and determination.
• Ability to set, meet, and exceed goals.
• Intermediate skills with Microsoft Office (Excel, Word, Outlook, PowerPoint)
• Ability to manage multiple claims while maintaining meticulous records.
• Problem-solving skills to identify discrepancies and proactively resolve issues.
• Typing speed of 40 WPM preferred

• High School Diploma or equivalent required
• College Coursework preferred.
• Experience with the construction industry preferred.
• Proficiency in Salesforce and claims management systems preferred.

Duties: Responsible for responding to routine inquiries. Identifies incorrectly processed claims and completes adjustments and related reprocessing actions. Reviews and adjudicates claims and/or non-medical appeals. Determines whether to return, deny or pay claims following organizational policies and procedures. 40% responds to written and/or telephone inquiries according to desk procedures.

Max Pay Rate: $19.72 Contract to hire

Schedule: M-F 7:30-4:00 or 8:00-4:30

Video Interview Training will be approximately 2 weeks

Onsite Role

Preferred/Nice To Have Skill Sets/Qualities:

• Attention to detail
• Great at documentation
• Microsoft software is preferred

Job Description: Provides prompt, accurate, thorough and courteous responses to all com.