Claims Service Specialist (Remote)

Claims Service Specialist (Remote)

At Globe Life, we are committed to empowering our employees with the support and opportunities they need to succeed at every stage of their career. Our thriving and dynamic community offers ample room for professional development, increased earning potential, and a secure work environment.

We take pride in fostering a caring and innovative culture that enables us to collectively grow and overcome challenges in a connected, collaborative, and mutually respectful environment that calls us to help Make Tomorrow Better.

Role Overview : Could you be our next Claims Service Specialist ? Globe Life is looking for a Claims Service Specialist to join the team!

In this role, you will be responsible for serving as a vital customer advocate within our Claims Department, expertly handling inquiries from policyholders and sales agents while delivering exceptional service. You'll guide customers through claims processes, explain policy details and claim statuses, and proactively resolve issues using your product knowledge and problem-solving skills.

Building strong relationships across teams, you'll work collaboratively to ensure positive outcomes for every customer interaction. This position offers the opportunity to make a meaningful impact in customers' lives while developing your expertise in a supportive environment where your passion for helping others drives world-class service delivery and business retention.

This is a remote / work from home position.

What You Will Do :

• Answer incoming phone calls promptly and return customer and agent calls by accurately analyzing insurance contracts, state-specific policy provisions, benefits, limitations, and exclusions.
• Handle customer and agent inquiries, issues, and complaints with timely research, follow-up, and professional resolution.
• Process health and accident claims daily by required deadlines, including reviewing claims documents, medical records, provider bills, receipts, and invoices to approve or deny benefits.
• Apply knowledge of underwriting health questions and medical terminology related to policy applications, waiting periods, and pre-existing conditions.
• Review system memos and documents efficiently to explain claims status, benefit payments, denials, appeal decisions, and required information for pending claims.
• Ensure customer and agent satisfaction on every interaction while documenting all phone calls, issues, and correspondence in system memos and claim files.
• Meet quality assurance requirements, key performance metrics, and maintain productivity standards.
• Cross-train with other operational departments on functions affecting claims, including premium deductions, policy limits, cash value, return of premium, and maturity processes.
• Process and respond promptly to miscellaneous requests by mailing claim forms, information release authorizations, EOBs, pending or denial letters, and duplicate policies.
• Communicate pertinent information or problems promptly to management.
• Identify and recommend process improvements, procedural enhancements, and system upgrades.
• Understand processes in Underwriting, Customer Service, Billing, and Corporate Services departments.
• Complete mandatory training required by auditors, compliance teams, and state regulations.

What You Can Bring :

Applicable To All Employees of Globe Life Family of Companies :

How Globe Life Will Support You :

Looking to continue your career in an environment that values your contribution and invests in your growth? We've curated a benefits package that helps to ensure that you don't just work, but thrive at Globe Life :

Opportunity awaits! Invest in your professional legacy, realize your path, and see the direct impact you can make in a workplace that celebrates and harnesses your unique talents and perspectives to their fullest potential. At Globe Life, your voice matters.