Claims Call Center Specialist I / Starting date 08-06-2021 in Tijuana at Integon Service Co.

Date Posted: 7/5/2021

Job Snapshot

Job Description

Primary Purpose:

Answer questions pertinent to an existing insurance claim (e.g. insured was involved in a car accident, etc.) and determine appropriate course of action.  Initial loss taking and claim set-up includes but is not limited to: recognizing and opening appropriate exposures based on facts of loss, documenting specific details of loss in our claims systems, selling company programs, validation claim assignment, using judgment and initiative to determine what additional service or assistance is warranted under the particular call and transferring the caller to the appropriate claim representative and/or work group. Responsible for handling new loss reports ranging from severe human trauma to minor accidents/incidents. Responsible for maintaining and growing a relationship between Integon Service Co and current policyholders. Also responsible for focusing on the needs of loss participants.  Identifies customer needs and works to meet those needs using appropriate customer service skills.


Training Start Date: June 3rd, 2019


Essential Duties and 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. 

  • Successfully completes the Claims Service Consultant Training Program and demonstrates the skills learned
  • Service policyholders calling to file a claim while maintaining an emphatic tone of voice and attitude, depending on the type of claim
  • For all duties and responsibilities, incumbent will take ownership of any issue, problem, or error that could potentially impact the loss participant
  • Secures new loss reports and loads the loss into the appropriate system. Follow through with clearly identifying expected services that will be offered throughout the claims experience
  • Learns to identify exposures and properly sets up new loss
  • Develops familiarity with claims related to all lines of company business
  • Transfers calls to the appropriate file handler
  • Answers general status inquiries from claimants, insureds, agents, and others. Develops knowledge about the entire claims process to respond to questions and properly route the call
  • Recognizes opportunities to offer tow, make Direct Repair shop recommendations and offer other company programs as necessary
  • May train and mentor less experienced personnel.
  • Performs other projects and assignments as directed

Job Requirements

Minimum Skills and Competencies:

The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Fully bilingual in English and Spanish.
  • High School diploma or equivalent (GED)
  • Demonstrates working knowledge of the claim system(s) – Preferred, not required
  • Bilingual proficiency (English and Spanish) is a must with excellent grammar
  • Demonstrates professional phone etiquette
  • Demonstrates a familiarity with company policies/ procedures
  • Demonstrates a working knowledge of departmental organizational structure/function
  • Demonstrates a basic understanding of the insurance industry
  • Demonstrates effective interpersonal skills
  • Associates or Bachelor degree preferred or equivalent related customer service experience
  • Demonstrates an understanding of the unit’s processes, work practices and procedures and their relationship to other functions
  • Ability to resolve conflicts and empathize with customers is critical
  • Requires knowledge of how to perform a variety of duties or how to operate standard equipment:
    • type 30 wpm
    • Intro to Excel, Word, Outlook
    • prior PC experience with advanced navigation through different windows and software applications 
  • Demonstrates a thorough understanding of the Integon brand and ability to exhibit the behaviors associated with it
  • High degree of initiative, mature judgment, and discretion


Desired Skills:

  • Previous experience in insurance customer service with personal auto, commercial, motorcycle, recreational vehicle, accident and health, supplemental health, and/or homeowners products is preferred


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