Claims Specialist Job Description

Claims Specialist Job Description

A Claims Specialist plays a key role in the automobile, home, health, and business insurance industry. Also known as claims examiners, or claims consultants, their main responsibilities include processing claims, negotiating settlements, verifying insurance coverage, and reviewing insurance cases.

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Claims Specialist Job Description:

We are looking for a highly-analytical Claims Specialist to join our company’s insurance department. You will be responsible for reviewing client claims, determining allowable benefits, and if necessary, provide professional testimony in a court of law.

While most of your work will be performed in the office, there will be some traveling required to conduct field visits, interviews, and research. The chosen candidate will be professional, highly-analytical, and possess in-depth knowledge of the latest policies and regulations in the insurance industry.

Responsibilities:

  • Analyze and investigate complicated insurance claims to help prevent fraud.
  • Perform detailed site inspections.
  • If necessary, provide well-informed court testimonies.
  • Review and process new claims reports and court verdicts.
  • Uphold relationships and communication with insurance departments and clients.
  • Organize and present claim review plans.
  • Negotiate settlements.
  • Resolve claims in a timely manner.
  • Stay up-to-date on local, state and federal law changes in the insurance field.

Requirements:

  • High school diploma or equivalent.
  • A minimum of 3 years’ in a similar position.
  • Strong analytical and organizational skills.
  • Excellent knowledge of the latest local, state and federal insurance-related policies.
  • Superb interpersonal and communication skills.
  • Good understanding of insurance claims negotiation and settlement techniques.

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