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Associate Claims Customer Service Jobs (NOW HIRING)

AF Group

Claims Customer Service Representative - CA

... customer service process associated with workers compensation claims which includes servicing ... Minimum of an Associate's degree in insurance or related field, but a combination of education and ...

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Associate Claims Customer Service information

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How much do associate claims customer service jobs pay per hour?

As of Sep 11, 2026, the average hourly pay for associate claims customer service in the United States is $19.85, according to ZipRecruiter salary data. Most workers in this role earn between $16.83 and $21.63 per hour, depending on experience, location, and employer.

What is the difference between Associate Claims Customer Service vs Claims Adjuster?

AspectAssociate Claims Customer ServiceClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may prefer insurance-related certificationsHigh school diploma; state licensing or certification often required
Work EnvironmentOffice setting, customer service calls, data entryFieldwork and office, investigating claims
Employer & Industry UsageInsurance companies, customer service centersInsurance companies, claims departments
Common Search & Comparison IntentUnderstanding entry-level roles in claims supportUnderstanding claims investigation and settlement roles

The Associate Claims Customer Service role primarily involves assisting policyholders, answering inquiries, and processing claims in an office environment. In contrast, Claims Adjusters investigate claims, assess damages, and determine settlement amounts, often involving fieldwork. While both roles are integral to the insurance industry and require similar certifications, their responsibilities and work settings differ significantly.

Is claims processing a stressful job?

Claims processing for an Associate Claims Customer Service role can be stressful due to tight deadlines, high call volumes, and the need for accuracy. Employees often handle complex cases and must maintain attention to detail while managing customer expectations in a fast-paced environment.

What is the work of an associate claims customer service?

An associate claims customer service representative handles inquiries from policyholders regarding insurance claims, assists with claim filing, provides status updates, and helps resolve issues related to claims processing. They often use claims management software and need strong communication skills to ensure accurate and efficient service.

What cities are hiring for Associate Claims Customer Service jobs?

Cities with the most Associate Claims Customer Service job openings:

What states have the most Associate Claims Customer Service jobs?

States with the most job openings for Associate Claims Customer Service jobs include:

What are popular job titles related to Associate Claims Customer Service jobs?

For Associate Claims Customer Service jobs, the most frequently searched job titles are:

Associate Claims Customer Service jobs near you

Claims Customer Service Representative

Lansing, MI • On-site

Emergent Holdings
Insurance Services • 501 - 1,000 employees
Learn more about Emergent Holdingsexternal

Full-time

Posted 15 days ago

Job description


SUMMARY:
Primarily responsible for the customer service process associated with workers compensation claims which includes servicing customers who contact us via the ACD phone line and supporting the claims management process for all claims teams across the Enterprise. Acts as a back up to the claims intake process. Acts as a backup to the Service Center Business Development and Provider Relations teams on the ACD phone line.
Note- This position has an end time of 6:00 pm.
PRIMARY RESPONSIBILITIES:
Supports the customer service work and processes for the Enterprise claims teams as well as the Subrogation Teams.
  1. Answers claim inquiries from policyholders, agents, injured workers, attorneys, pharmacies, medical providers for multiple jurisdictions for the Enterprise claims teams. Provides verification of claim status for multiple jurisdictions using multiple technology sources.
  2. Performs all facets of IME's, AME's, DDE's, QME's and any other independent type evaluation needed for the claim file.
  3. Provides backup as needed to Claims Document Analysts to review and analyze incoming documents and assign the appropriate document sub type to them.
  4. Reviews each document and adds pertinent information to the document keywords and to appropriate data fields in the claim system.
  5. Re-indexes and appropriately routes documents that have been assigned an improper document type or have been attached to an incorrect claim.
  6. Assists with the resolution of FROI errors.
  7. Adds legal matters and pertinent litigation information to the claim system upon receipt of legal documents.
  8. Reviews, researches, and properly routes all unidentified claims mail for all brands within the Enterprise.
  9. Provides backup to the Claims Processing Associates for review, research, and proper routing of priority unidentified claims mail for all brands within the Enterprise.
  10. Processes Claims Subpoenas. Performs all facets of the following referrals: Utilization review, Medical Management, Vocational Rehabilitation, Litigation, and all other Vendor Referrals as requested.
  11. Participates in projects to improve processing and workflow.
  12. Provides PPO, MPN, HCN provider names and/or general program information to customers
  13. Updates claim system with vital information changes.
  14. Updates document management system when claim number changes occur.
  15. Provides backup to intake for multi-state claims processing.
  16. Produces forms, memos, reports, information and letters as requested.
  17. Provides policyholders, agents, and others as requested with copies of first report of injuries.
  18. Corrects department and location information on loss runs as requested.
  19. Inputs data into legal billing system.

  1. Inputs notes into medical bill review web based system for disputes/denials.
  2. Manually produces claim welcome packets as requested.
  3. Researches outstanding checks for escheatment process and mails form letter to check recipient if applicable.
  4. Forwards travel documents back to sender requesting additional information.
  5. Types, photocopies, faxes as necessary.
  6. Organizes file materials in date order to be provided to various attorneys and vendors either via the vendor portal or another delivery method.
  7. Assigns services requests to TPA and other vendors via the vendor portal.
  8. Communicates with appropriate state WC division to discuss various issues.
  9. Makes contact with employer and/or injured worker if necessary to obtain information.
  10. May participate with training of team members.
  11. Serves as a resource with creation of documentation of general and state specific procedures as it relates to this position.
  12. Communicates and collaborates with team members to ensure the appropriate and timely handling of claims.
  13. Performs all tasks specified for multiple jurisdictions for all Enterprise Claims Teams.

This description identifies the responsibilities typically associated with the performance of the job. The percentage of time in any responsibility may vary between positions. Other relevant essential functions may be required.
EMPLOYMENT QUALIFICATIONS:
  1. EDUCATION REQUIRED: (Brief paragraph detailing the minimum education required, including certifications) Do not state preferred qualifications.

High School Diploma or G.E.D. required. Minimum of an Associates degree in insurance or related field, but a combination of education and experience may be considered in lieu of formal education.
  1. EXPERIENCE REQUIRED: (Minimum experience required to perform this job) Do not state preferred experience.

Minimum of three years general office experience including a minimum of one year in workers' compensation insurance. Prior experience answering inquires over the phone at AF Group or equivalent relevant internal experience that would provide the required skills, knowledge and abilities. Relevant customer service experience exchanging information and answering basic inquiries over the phone is required
OR
Minimum of four years of general office experience. Two years of customer service experience answering inquiries over the phone in an insurance organization. Prior equivalent relevant experience that would provide the required skills, knowledge and abilities may be considered.
  1. SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED: (Brief bullet points detailing the skills, knowledge, and abilities required for this job. SKA's should tie back to the primary responsibilities required)
  2. Basic knowledge of insurance claims excellent customer service skills.
  3. Excellent telephone etiquette.
  4. Excellent verbal and written communication skills.
  5. Excellent organizational skills and ability to prioritize work.
  6. Ability to manage multiple priorities and meet established deadlines.
  7. Knowledge of multi functional telephone system.
  8. Ability to research information in multiple systems.
  9. Ability to obtain pertinent and thorough information from customers.
  10. Ability to be an independent thinker to solve issues.
  11. Ability to work effectively with various business units.
  12. Excellent organizational skills and ability to prioritize work to meet established deadlines.
  13. Knowledge of computers and spreadsheet software.
  14. Ability to proofread correspondence for accuracy of spelling, grammar, punctuation, and format.
  15. Knowledge of word processing software with data entry ability of 40 w.p.m.
  16. Ability to verify data for accuracy.
  17. Knowledge of medical terminology.
  18. Knowledge of legal terminology.
  19. Ability to multi-task, i.e. interacts on telephone while entering data.
  20. Ability to train and coach others to perform the core responsibilities.
  21. Ability to work varied hours/days/shifts.
  22. Ability to assist with the creation of procedural documentation and workflows.
  23. ADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE AND/OR ABILITIES PREFERRED: (Briefly detail the preferred education, experience, skills, knowledge and/or abilities desired to perform this job, including certifications). These are in addition to the required qualifications - Do not state required qualifications.
  • Insurance Institute of America (IIA) Certification
  • Experience handling claims in multiple states.
  • Experience on an ACD telephone system
  • Experience using a document management system with workflows
  • Knowledge of CPT, ICD9 and 10, and drug codes

WORKING CONDITIONS:
Work is performed in an office setting with no unusual hazards. This position has an ending time of 6:00 pm.
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