Claims Support Operations

JOB SUMMARY:

The Claims Support Operations team serves as a critical support function within the claims call center, ensuring adjusters can focus on claim resolution by handling administrative, operational, and customer support tasks. This role supports claim lifecycle activities, improves efficiency, and enhances the overall customer and adjuster experience.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Claim Intake & Setup

• Assist with First Notice of Loss (FNOL) processing and claim setup

• Verify policy information and ensure accurate data entry into claims systems

Administrative Support

• Manage claim documentation, including uploading, indexing, and organizing files

• Process incoming correspondence (email, fax, mail) and route appropriately

• Prepare standard letters, forms, and claim-related communications

• Maintain accurate and up-to-date claim records

• Assist in gathering required documentation for claim investigations such as Vehicle Registration Reports, Police Reports and ISO Reports

• Communicate with internal departments and vendors to obtain or relay information

Adjuster Support

• Handle inbound and outbound calls on behalf of adjusters when appropriate

• Schedule inspections, appraisals, and vendor appointments

• Follow up on outstanding documentation (police reports, medical records, etc.)

• Provide status updates to customers, agents, and third parties

Customer Service

• Serve as a point of contact for basic claim inquiries

• Deliver timely and professional communication aligned with service standards

• Escalate complex or sensitive issues to adjusters or leadership

Operational Efficiency

• Support workload balancing and queue management

• Monitor task queues and ensure SLAs are met

• Identify process improvement opportunities and escalate trends

Compliance & Quality

• Ensure adherence to regulatory requirements and company policies

• Maintain confidentiality and data security standards

• Participate in quality assurance programs and coaching sessions

Key Performance Indicators (KPIs)

• Turnaround time for claim setup and administrative tasks

• Accuracy and quality of claim documentation

• Service Level Agreement (SLA) adherence

• Call handling metrics (AHT, FCR where applicable)

• Customer satisfaction (CSAT) scores

• Adjuster satisfaction / support effectiveness