Description:
PRIMARY PURPOSE: To process claims and determine benefits due pursuant to credit card or other financial program benefits plans; to make timely payments and adjustments for specified program claims; and to provide superior customer service.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Processes first party property claims based on basic coverage as defined by client-specific program.
Makes coverage determinations based on investigation/evaluation.
Adjudicates proper settlement or denials up to designated authority level.
Handles high volume of claims, phone calls and correspondence ensuring claim files are properly documented; meets quality and production goals; and meets customer guidelines and deadlines.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
Requirements:
100% REMOTE, No California or NY hires please.
Start date: 10-6-25
End date: 3/28/26 for right now but we continuously evaluate business need and performance
WORK SCHEDULE: MUST WORK EST, Monday through Friday 8 am to 4:30 pm EST with a 30 min lunch, willing to work with contractor on start and end time but core hours are 8 am to 5 pm EST
TRAINING SCHEDULE: Monday through Friday 8 am to 5 pm EST with a 1 hour lunch
Background – Standard Package with Credit check
BGC needs to be cleared before 1st week of OCT
After training the contractor can pick the schedule below. we have some flexibility with them having a start time between 8:00am EST-9:30am EST but would prefer the schedules below. The time is fixed once they decide.
Equipment will be provided (desktop, monitors, keyboard, mouse, phone/headset) but they may need to use a personal device to attend at the start of training. This will depend on arrival of equipment. They are required to be on camera during our remote training classes. It is their responsibility to have a strong home internet provider. We will need to confirm the Company of their internet supplier as well since Telecommunication 5G home internet is not compatible with our equipment.
Criminal screens must be completed prior to starting.
QUALIFICATIONS
Education & Licensing High school diploma or GED required. They do not need to be licensed.
One (1) year of general office experience with claim processing experience, able to meet daily quotas, fast paced and high volume.
equivalent combination of education and experience required. Claims industry experience preferred. Candidates need to be quick decision makers and be able to work in fast paced environment.
Skills & Knowledge
Knowledge and experience of first party property and casualty claim processing
Good oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Good organizational skills
Good interpersonal skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies
WORK ENVIRONMENT - When applicable and appropriate, consideration will be given to reasonable accommodations.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Physical: Computer keyboarding, travel as required
Auditory/Visual: Hearing, vision and talking
Nesco Resource offers a comprehensive benefits package for our associates, which includes a MEC (Minimum Essential Coverage) plan that encompasses Medical, Vision, Dental, 401K, and EAP (Employee Assistance Program) services.
Nesco Resource provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.