Virtual Insurance Claims Representative

Vintti is a staffing agency that acts as an economic enabler. By connecting US-based SMBs, startups, and firms with top-tier Latin American talent, we drive growth on both sides of the equation. For US businesses, we offer access to a pool of highly skilled professionals at competitive rates, allowing for increased efficiency and scalability. For Latin American workers, we provide opportunities to engage with the US market, fostering professional development and economic advancement. Vintti stands at the intersection of global talent and American enterprise, facilitating partnerships that stimulate economic prosperity across borders.

A Virtual Insurance Claims Representative plays a crucial role in the insurance industry by efficiently managing and processing claims remotely. This position involves evaluating insurance claims, communicating with claimants, policyholders, and other stakeholders, and ensuring a smooth and accurate claims process. Responsibilities often include gathering detailed information, reviewing documentation, investigating the validity of claims, and making appropriate decisions regarding payouts. Excellent communication skills, attention to detail, and the ability to work independently are essential for success in this role, as it helps maintain customer satisfaction while ensuring compliance with company policies and regulations.

- Bachelor's degree in business, finance, insurance, or a related field.
- Minimum of 2 years of experience in insurance claims processing or a related role.
- Strong knowledge of insurance policies, regulations, and claims procedures.
- Proficiency in claims management software and Microsoft Office Suite.
- Excellent verbal and written communication skills.
- Strong analytical and problem-solving abilities.
- Attention to detail and a high level of accuracy in work.
- Strong organizational skills and ability to manage multiple tasks simultaneously.
- Ability to handle sensitive information with confidentiality and professionalism.
- Customer service skills with a focus on empathy and resolution.
- Ability to work independently and as part of a remote team.
- Strong time management skills and ability to meet deadlines.
- Flexibility to adapt to changing regulations and policies.
- Experience in identifying and handling potential fraudulent claims.
- Capability to conduct virtual meetings using video conferencing tools.

- Review insurance claims to determine coverage and liability.
- Communicate with policyholders, claimants, and third parties via phone, email, and chat.
- Document detailed notes on interactions and findings in the claims management system.
- Verify and process claim forms and supporting documentation.
- Investigate discrepancies and obtain missing information.
- Coordinate with underwriting and legal departments to resolve complex claims.
- Assess validity of claims and make decisions on payment or denial.
- Prepare and issue claims payment instructions to finance.
- Calculate and issue settlement offers to claimants or representatives.
- Handle and resolve customer inquiries and complaints.
- Schedule and conduct virtual meetings with claimants and stakeholders.
- Stay updated on changes in insurance regulations and industry practices.
- Prepare detailed reports on claim statuses and outcomes.
- Identify and escalate potential fraudulent claims.
- Participate in training sessions and team meetings.

The ideal candidate for the role of Virtual Insurance Claims Representative will possess a Bachelor's degree in business, finance, insurance, or a related field, coupled with a minimum of 2 years of hands-on experience in insurance claims processing or a closely related role. This individual will have a robust understanding of insurance policies, regulations, and claims procedures, matched by proficiency in claims management software and the Microsoft Office Suite. They will demonstrate exceptional verbal and written communication skills and exhibit strong analytical and problem-solving abilities. Attention to detail and a high level of accuracy will be second nature to this candidate, and they will excel in organizational skills, adeptly managing multiple tasks simultaneously while adhering to deadlines. The ideal candidate will be capable of handling sensitive information with the utmost confidentiality and professionalism, and will bring high levels of empathy and resolution-focused customer service skills. They will be a proactive problem solver, able to work independently and as a part of a remote team, showing a strong commitment to ongoing learning and development. Adaptability to evolving regulations and policies will be essential, as will their experience in identifying and preventing fraudulent claims. Moreover, they will be well-versed in conducting virtual meetings using video conferencing tools, and they will bring a results-driven mindset and a dedication to continuous improvement, making them an exemplary addition to our team.

- Review and analyze insurance claims to determine coverage and liability.
- Communicate with policyholders, claimants, and third parties via phone, email, and chat to gather necessary information.
- Document detailed notes on all interactions and findings in the claims management system.
- Verify and process claim forms and supporting documentation.
- Investigate discrepancies and obtain missing information to complete claims files.
- Coordinate with internal departments, such as underwriting and legal, to resolve complex claims issues.
- Assess the validity of claims and make decisions regarding payment or denial based on policy terms.
- Prepare and issue claims payment instructions to the finance department.
- Calculate and issue settlement offers to claimants or their representatives.
- Handle and resolve customer inquiries and complaints regarding claims.
- Schedule and conduct virtual meetings with claimants and stakeholders as needed.
- Stay updated on changes in insurance regulations, policies, and industry best practices.
- Prepare detailed reports on claim statuses and outcomes for management review.
- Identify potential fraudulent claims and escalate them for further investigation.
- Participate in training sessions and team meetings to continuously improve skills and knowledge.

- Strong analytical thinking
- Detail-oriented
- Excellent communication skills
- High level of accuracy
- Proactive problem solver
- Strong organizational skills
- Empathy and customer-focused
- Confidentiality in handling sensitive information
- Ability to work independently
- Team player in a remote environment
- Strong time management skills
- Adaptability to changing regulations and policies
- Digital proficiency with claims management software
- Familiarity with video conferencing tools
- Experience in fraud detection and prevention
- Results-driven mindset
- Commitment to ongoing learning and development

- Competitive salary ranging from $50,000 to $70,000 per year
- Health, dental, and vision insurance
- 401(k) plan with company match
- Paid time off (PTO) and holidays
- Flexible work schedule
- Remote work opportunities
- Professional development and training programs
- Tuition reimbursement
- Employee assistance program (EAP)
- Wellness programs and resources
- Life and disability insurance
- Performance bonuses
- Career advancement opportunities
- Paid parental leave
- Employee discounts and perks