Physicians Insurance A Mutual Company logo
Physicians Insurance A Mutual Company

Protecting, defending, and supporting our Members with expertise, commitment, and a people-first approach.

Claims Service Associate

Claims SpecialistClaims SpecialistFull TimeRemoteMid LevelTeam 51-200Since 1982H1B No SponsorCompany SiteLinkedIn

Location

Washington

Posted

1 day ago

Salary

$70.8K - $105.8K / year

Seniority

Mid Level

High School3 yrs expEnglish

Job Description

Claims Service Associate

Physicians Insurance A Mutual Company

• Responsible for the timely and accurate intake, triage, and system setup of reported incidents, claims, and lawsuits. • Serve as the first point of contact for insured members, brokers, and internal departments. • Provide professional, responsive customer experience while gathering, validating, and documenting critical claim information. • Perform limited claim handling within established authority and supports efficient claims assignment and workflow coordination across the Claims Department. • Gather, review, and document comprehensive First Notice of Loss (FNOL) information and supporting documentation to ensure absolute data accuracy and completeness prior to assignment. • Analyze incoming reports for severity, urgency, and coverage considerations; exercise independent judgment to escalate high-priority, complex matters to Claims Management while handling first-tier issues autonomously. • Complete accurate claim setup by verifying applicable coverages, tail endorsements, and policy limitations within the system, and generate formal acknowledgment correspondence. • Maintain precise system data, track intake metrics, and process regulatory reporting or referrals (such as Litigation and Peer Support Programs) in collaboration with Legal and Compliance teams. • Utilize departmental systems, tracking software (including Breezy ATS workflows where applicable), and applications to support daily intake activities, minimize processing lag, and drive process improvements.

Job Requirements

  • High school diploma or equivalent required; additional education, insurance coursework, or industry training preferred.
  • Three to five years of experience in administrative, customer service, claims, operations, or related analytical role.
  • Insurance experience preferred, especially in medical malpractice, professional liability, or related coverage areas.
  • Strong attention to detail with the ability to enter, review, and maintain accurate claim information and documentation.
  • Ability to review information, assess urgency or complexity, manage shifting priorities, and escalate issues appropriately.
  • Excellent organizational, time management, and coordination skills, with the ability to manage competing priorities in a fast-paced environment.
  • Strong written and verbal communication skills, with a customer-focused approach and the ability to work effectively with internal teams and external stakeholders.
  • Knowledge of basic coverage principles, claim processes, and medical terminology preferred.
  • Experience using workflow, claims, or case management systems preferred; ability to learn and adapt to new tools, software, and processes required.
  • Proficiency with Microsoft Word and Outlook required; strong typing skills preferred.
  • Ability to work independently and collaboratively while demonstrating professionalism, sound judgment, and integrity.

Benefits

  • Comprehensive benefits program
  • Generous retirement program
  • Paid Time Off
  • Annual company bonus at an incentive target level of 5%

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