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Claims Resolution Specialist

CRC Group
Flower Mound, USA
Full-time
Junior · 1–2 years experience
Onsite
Discovered 2 weeks ago
Communication

Full Job Posting

KEY RESPONSIBILITIES:

  • Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.
  • Assist in the intake and setup of new claims in the system. • Collect and verify required documentation from internal and external stakeholders. • Provide administrative support for claims adjusters, including file organization and data entry. • Monitor and follow up on claim status to ensure timely resolution. • Communicate with claimants and other parties to update on claim progress as directed. • Ensure compliance with regulatory standards and internal policies. • Escalate issues or discrepancies to supervisor for resolution. • Maintain accurate and up-to-date claim records within the claims management platform.
  • Assist in the intake and setup of new claims in the system.
  • Collect and verify required documentation from internal and external stakeholders.
  • Provide administrative support for claims adjusters, including file organization and data entry.
  • Monitor and follow up on claim status to ensure timely resolution.
  • Communicate with claimants and other parties to update on claim progress as directed.
  • Ensure compliance with regulatory standards and internal policies.
  • Escalate issues or discrepancies to supervisor for resolution.
  • Maintain accurate and up-to-date claim records within the claims management platform.

EDUCATION AND EXPERIENCE

  • The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
  • High school diploma or equivalent required. • Associate degree or progress toward a bachelor's degree preferred. • 1–2 years of experience in claims administration, insurance support, or related financial/administrative role preferred. • Proficiency in using claims management systems and Microsoft Office applications.
  • CERTIFICATIONS / LICENSES / REGISTRATIONS
  • No specific criteria is required.
  • FUNCTIONAL SKILLS
  • Basic understanding of insurance terminology and claim processes. • Data entry accuracy and attention to detail. • Ability to manage multiple tasks and meet deadlines. • Effective verbal and written communication skills. • Problem-solving and critical thinking in routine situations. • Customer service orientation with ability to handle sensitive information with confidentiality.
  • General Description of Available Benefits for Eligible Employees of CRC Group: At CRC Group, we're committed to supporting every aspect of teammates' well-being – physical, emotional, financial, social, and professional. Our best-in-class benefits program is designed to care for the whole you, offering a wide range of coverage and support. Eligible full-time teammates enjoy access to medical, dental, vision, life, disability, and AD&D insurance; tax-advantaged savings accounts; and a 401(k) plan with company match. CRC Group also offers generous paid time off programs, including company holidays, vacation and sick days, new parent leave, and more. Eligible positions may also qualify for restricted stock units and/or a deferred compensation plan.
  • CRC Group supports a diverse workforce and is an Equal Opportunity Employer that does not discriminate against individuals on the basis of race, gender, color, religion, citizenship or national origin, age, sexual orientation, gender identity, disability, veteran status or other classification protected by law. CRC Group is a Drug Free Workplace.
  • EEO is the Law Pay Transparency Nondiscrimination Provision E-Verify
  • High school diploma or equivalent required.
  • Proficiency in using claims management systems and Microsoft Office applications.
  • Basic understanding of insurance terminology and claim processes.
  • Data entry accuracy and attention to detail.
  • Ability to manage multiple tasks and meet deadlines.
  • Effective verbal and written communication skills.
  • Problem-solving and critical thinking in routine situations.
  • Customer service orientation with ability to handle sensitive information with confidentiality.

Preferred Qualifications

  • Associate degree or progress toward a bachelor's degree preferred.
  • 1–2 years of experience in claims administration, insurance support, or related financial/administrative role preferred.

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