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Direct Claims Jobs in Delaware (NOW HIRING)

Walgreens

Pharmacy Customer Service Associate

Newark, DE · On-site

In accordance with state and federal regulations, assists the pharmacist, under direct supervision ... Processes (corrects and resubmits) manual claims for third party program prescription services in a ...

Walgreens

Pharmacy Customer Service Associate

Dover, DE · On-site

In accordance with state and federal regulations, assists the pharmacist, under direct supervision ... Processes (corrects and resubmits) manual claims for third party program prescription services in a ...

Walgreens

Pharmacy Customer Service Associate

Newark, DE · On-site

In accordance with state and federal regulations, assists the pharmacist, under direct supervision ... Processes (corrects and resubmits) manual claims for third party program prescription services in a ...

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All JobsDirect Claims JobsDirect Claims Jobs in Delaware

Direct Claims information

What is a direct claim?

Direct claims refer to insurance claims that are filed directly by the policyholder with their own insurance company, rather than going through a third party or the at-fault party's insurer. This process is common in situations like auto accidents, where the policyholder seeks compensation for damages or losses under their own policy. Direct claims help streamline the process, reduce delays, and ensure the policyholder receives prompt assistance and settlements. They are often associated with 'first-party' insurance coverage, such as collision, comprehensive, or health insurance claims.

Can you work remotely in direct claims jobs?

Many direct claims jobs offer remote work options, especially for roles involving claims processing, customer service, or administrative tasks. Employers may require familiarity with claims management software and good communication skills, and remote positions often involve standard office hours and secure internet connections.

Do I need a degree to be a direct claims specialist?

A degree is not typically required to become a direct claims specialist, but relevant experience, knowledge of insurance policies, and strong communication skills are important. Many employers provide on-the-job training and may prefer candidates with a high school diploma or equivalent. Certifications in insurance or claims processing can enhance job prospects.

What are some common challenges faced by professionals in direct claims roles, and how can they effectively manage these challenges?

Professionals in Direct Claims often face the challenge of balancing a high volume of claims with the need for thorough investigation and timely resolution. Managing customer expectations and handling sensitive situations, such as denied claims or complex cases, can also be demanding. Effective communication, strong organizational skills, and staying updated on policy guidelines are crucial for success. Building collaborative relationships with adjusters, underwriters, and other departments helps ensure accurate and efficient claims processing.

What are the key skills and qualifications needed to thrive as a direct claims specialist?

To thrive as a Direct Claims Specialist, you need a solid understanding of insurance policies, claims processes, and relevant legal regulations, often supported by a degree in business, finance, or a related field. Familiarity with claims management software, customer relationship management (CRM) systems, and sometimes industry certifications like AIC or CPCU is typical. Exceptional attention to detail, problem-solving abilities, and strong communication skills set top performers apart in this role. These skills and qualifications ensure claims are processed accurately and efficiently, leading to customer satisfaction and minimized risk for the insurer.

What is the difference between Direct Claims vs Claims Adjuster?

AspectDirect ClaimsClaims Adjuster
CredentialsInsurance license, knowledge of policiesInsurance license, sometimes certifications like AIC or CPCU
Work EnvironmentCustomer service, office or remoteFieldwork, office, or remote
Employer & IndustryInsurance companies, agenciesInsurance companies, third-party administrators
Search & Comparison IntentUnderstanding direct claims handlingEvaluating claims adjustment roles

Direct Claims professionals primarily handle claims directly from policyholders, focusing on processing and resolving claims within the insurance company. Claims Adjusters evaluate, investigate, and settle claims, often working in the field or remotely. Both roles require insurance licensing, but Claims Adjusters may have additional certifications. While their work overlaps in claims processing, Direct Claims roles are more customer-facing, whereas Claims Adjusters focus on assessment and negotiation.

What are popular job titles related to Direct Claims jobs in Delaware? For Direct Claims jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Direct Claims jobs in Delaware look for? The top searched job categories for Direct Claims jobs in Delaware are:
What cities in Delaware are hiring for Direct Claims jobs? Cities in Delaware with the most Direct Claims job openings:
Direct Claims jobs near you

Pharmacy Customer Service Associate

Walgreens

Milford, DE • On-site

Other

Re-posted 17 days ago

Walgreens rating

5.5

Company rating: 5.5 out of 10

Based on 2,188 frontline employees who took The Breakroom Quiz

99th of 112 rated pharmacies

Job description

  • Models and delivers a distinctive and delightful customer experience.
  • Registers sales on assigned cash register, provides customers with courteous, fair, friendly, and efficient checkout service.
  • In accordance with state and federal regulations, assists the pharmacist, under direct supervision, in the practice of pharmacy.  Responsible for using pharmacy systems to obtain patient and drug information and process prescriptions.
Customer Experience
  • Engages customers and patients by greeting them and offering assistance with products and services.  Resolves customer issues and answers questions to ensure a positive customer experience.
  • Models and shares customer service best practices with all team members to deliver a distinctive and delightful customer experience, including interpersonal habits (e.g., greeting, eye contact, courtesy, etc.) and Walgreens service traits (e.g., offering help proactively, identifying needs, servicing until satisfied, etc.).
Operations
  • Provides customers with courteous, friendly, fast, and efficient service.
  • Recommends items for sale to customer and recommends trade-up and/or companion items.
  • Registers customer purchases on assigned cash register, collects cash and distributes change as requested; processes voids, returns, rain checks, refunds, and exchanges as needed.  Takes customer to OTC aisle when possible to assist in locating products.
  • Keeps counters and shelves clean and well merchandised, takes inventory, and maintains records.  Checks in and prices merchandise as required or as directed by store manager or communicated by the shift leader.
  • Performs duties as assigned by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring information is entered correctly,  filling prescriptions by retrieving, counting and pouring pharmaceutical drugs, verifying medicine is correct, and checking for possible interactions.  Assists pharmacists in scheduling and maintaining work flow.
  • Reports, immediately, prescription errors to pharmacist on duty and adheres to Company policies and procedures in relation to pharmacy errors and the Quality Improvement Program. Reviews and complies with the Walgreen Co. Pharmacy Code of Conduct.
  • Strictly adheres to the Walgreen Co. policy regarding Good Faith Dispensing during all applicable prescription dispensing activities.
  • Handles telephone calls that do not require personal attention of the pharmacist, including those to physicians.
  • Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient manner, and performs other clerical duties, as assigned by the Pharmacy Manager.
  • Assists and supports Pharmacy Department on inventory management activities, such as, ordering, unpacking, checking and storing shipment of pharmaceuticals.  Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages (merchandise billed, but not received), order errors or damaged goods involving Rx drugs.
  • Ensures compliance with state and local laws regarding regulated products (e.g., alcoholic beverages and tobacco products).
  • Constructs and maintains displays, including promotional, seasonal, super structures, and sale merchandise.  Completes resets and revisions as directed.
  • Assists with separation of food items (e.g., raw foods from pre-cooked) and product placement as specified by policies/procedures (e.g., raw and frozen meats on bottom shelves).  For consumable items, assists in stock rotation, using the first in, first out method and restock outs.
  • Has working knowledge of store systems and store equipment.
  • Provides customer service in the photo area, including digital passport photo service, poster print and creative machine, suggestive sell of promotional photo products.
  • Assumes web pick-up responsibilities (monitors orders in Picture Care Plus, fills orders (pick items), delivers orders to customers as they arrive at store).
  • Assists with exterior and interior maintenance by ensuring clean, neat, orderly store condition and appearance.
  • Complies with all company policies and procedures; maintains respectful relationships with coworkers.
  • Completes special assignments and other tasks as assigned.
Training & Personal Development
  • Earns and maintains PTCB certification through the designated PTCB training program and/or state required certification/registration.
  • Attends training and completes PPLs requested by Manager or assigned by corporate and acquires continuing education credits.  Maintains knowledge and skill in healthcare and pharmacy, including latest news and developments.

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