Claims Adjudicator I

National Automotive Experts Strongsville, OH
At this time a Claims Adjudicator I is needed to protect the interest of the administration company by gathering information to best assist and process claims by following the guidelines of each contract NAE/NWAN administers while providing knowledge to the customers and dealers. Focuses on "small" claims (claims with estimated dollar of no more than $1500). Answers inbound calls, reviews contract information and previous notes and makes claims requests decisions in a timely manner while maintaining a high level of professionalism and friendly customer service. Works with team and utilizes leadership for guidance.

We are hiring for the following schedules:

Full-time shifts available

Part-time shifts include: 10:00 am - 3:00 pm, Monday - Friday or 3:00 pm - 7:00 pm, Monday - Friday

Role and Responsibilities:

* Respond to inbound calls (general questions and claims requests) in a timely manner using the utmost professionalism.

* Gather information from customers, service advisors and dealers to help us make the best decision possible.

* Guide both customers and repair facilities through the claims process. Explain the information needed to process the claim as efficiently as possible.

* Take detailed notes of conversations. Provide that information in the contract as well as OAMS.

* Review estimate submitted by repair facility.

* Compare coverage on contract to estimate costs (pull parts & labor times in Mitchell or search for parts prices by using the internet or manufacturer's website).

* Pull maintenance schedules (utilize Edmunds or manufacturer resources); fill out maintenance sheet.

* Ensure understanding, is always aware of and follows special procedures that may be in place according to Dealer Notes.

* Request any additional information that you may need to make the best possible decision.

* Order inspection if required/ discrepancies.

* Escalate questionable claims to a supervisor or team lead.

* Authorize/Deny claims with authorization of up to $1500.

* Assist dealers with prepaid maintenance redemptions.

* Strive to enforce and live the NAE /NWAN Philosophy of CQSE each and every day.

* Other duties as needed.

Qualifications and Education Requirements:

* High School Diploma or equivalent.

* At least one-year previous customer service experience; preferably in a call center environment.

* Strong problem-solving skills.

* Clear demonstration of positive customer service skills.

* A high level of organizational skills.

* Clear and concise tone of voice that is consistently used.

* Ability to navigate through multiple computer software programs and the internet.

* Ability to type at least 40 wpm.

* Demonstrated high level of attention to detail.

* Ability to effectively communicate the same message to different audiences (people of different learning/understanding levels).

* Demonstrated ability to accurately document a recap of each situation which allows the reader to have a vision of the situation at hand.

* Natural good manners (shows respect to all, utilizes "feel, felt, found" in customer service transactions, is patience, etc.).

Work Environment and Physical Requirements:

* Normal office environment.

* Ability to frequently sit for long periods of time.

* Ability to occasionally walk, stand, reach with hands and arms, stoop, kneel or crouch.

* Ability to spend extended hours in front of a computer screen and use close vision, distant vision and depth perception.

* Ability to lift at least 20 pounds.

Preferred Skills:

* Strong understanding of all contracts administered by NAE.

* Previous claims administration experience.

* Ability to listen and identify customer needs and concerns.

* Previous experience in the automotive industry as a lube/oil change technician