Claims Specialist
Location: Lehi, UT
Job Type: Contract
Company: IDR
Category: All Other
Job Description Apply Now
The Claims Specialist is a vital member of the claims operations team, responsible for supporting the claims adjudication process and ensuring the accurate validation of coverage for customers. As a Claims Specialist, you will play an essential role in interpreting policy terms and conditions, efficiently responding to claims authorization requests, and communicating outcomes to stakeholders. This position is ideal for individuals who have a strong background in claims authorization or contact center environments and wish to contribute to a service-focused industry that values accuracy, compliance, and customer satisfaction.
Working as a Claims Specialist offers the opportunity to be part of a dynamic team in a company known for industry leadership and a commitment to employee success. You will work closely with various departments to support end-to-end claims processes, from initial authorization requests to final settlement offers and communication with customers. The role provides ongoing professional development and the chance to make a positive impact by supporting fair and timely claims resolution.
As a Claims Specialist, you will draw upon your attention to detail, analytical skills, and knowledge of contract language to assess eligibility and support customers throughout the claims journey. Your ability to interpret complex information, maintain confidentiality, and deliver clear communications will be essential to your success in this position. If you are seeking a rewarding career in claims operations with opportunities for advancement and a supportive team environment, consider applying today by clicking the job application button.
Claims Specialist - Summary- Integral member of the claims operations team focused on claims adjudication and coverage validation.
- Supports a high-volume, service-oriented environment dedicated to customer satisfaction and operational accuracy.
- Utilizes expertise in contract interpretation and claims processing to ensure compliance and fairness throughout the claims process.
- Engages with customers and internal teams to facilitate efficient claims authorization and resolution.
- Support the claims operation channel throughout the claim adjudication journey, ensuring claims are processed accurately and efficiently.
- Interpret policy terms and conditions to determine contractual obligations and validate customer coverage.
- Respond professionally to a high volume of claims authorization requests, maintaining a customer-focused approach at all times.
- Analyze claims by evaluating diagnosis, product details, and tenure, making informed decisions regarding eligibility.
- Process cash-settlement offers, dispatch contractor requests, and enforce contractor agreements as necessary.
- Communicate claim outcomes and next steps clearly to customers, ensuring transparency and satisfaction.
- Collaborate with internal stakeholders to address complex claims and provide solutions aligned with company policies.
- Maintain thorough records of all claims activity in compliance with company and regulatory standards.
- Competitive compensation package offered for the Claims Specialist position.
- Comprehensive benefits including medical, dental, vision, and life insurance.
- Access to an Employee Stock Ownership Program and retirement planning resources.
- Opportunities for professional growth within an industry-leading organization.
- Employee recognition and award programs, including multiple years of recognition by ClearlyRated’s Best of Staffing®.
- High school diploma or equivalent required for the Claims Specialist role.
- Minimum of two years' experience in claims authorization or a contact center environment.
- Proficiency in Microsoft applications, including Excel, PowerPoint, and Word.
- Demonstrated ability to interpret and evaluate contract language related to claim coverage.
- Excellent written and verbal communication skills, with strong attention to detail.
- Ability to manage multiple tasks and prioritize effectively in a fast-paced setting.
- Commitment to maintaining confidentiality and adhering to company and regulatory policies.
- Detail-oriented with strong analytical and problem-solving capabilities.
- Experience in a high-volume claims or customer service environment.
- Comfortable interpreting complex policy documents and contract language.
- Exceptional organizational skills and the ability to work independently or as part of a team.
- Passion for delivering excellent customer service and supporting positive outcomes for all parties involved.
- The organization has over 25 years of proven industry experience and is recognized for its dedication to employee success and engagement.
- Supportive management and ongoing training opportunities to help you advance your career as a Claims Specialist.
- Commitment to diversity, equity, and inclusion as reflected in the company’s hiring and employment practices.
- Positive mention: Working in Lehi, UT offers a dynamic business environment and access to a thriving professional community.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. IDR is subject to certain governmental recordkeeping and reporting requirements for the administration of civil rights laws and regulations. In order to comply with these laws, we invite employees to voluntarily self-identify their race or ethnicity, gender, and veteran status (if applicable). Submission of this information is voluntary and refusal to provide it will not subject you to any adverse treatment. The information obtained will be kept confidential and may only be used in accordance with the provisions of applicable laws, executive orders, and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement. You may access this form here.
If you are ready to take the next step in your career as a Claims Specialist, click the job application button to apply and join a team dedicated to your growth and success.