Gain insight into the essential qualifications, important duties, key responsibilities, and vital skills that form a well-rounded Claims Specialist job description.
What does a Claims Specialist do?
A claims specialist is an important role in the insurance industry, handling claims for various types of insurance such as automobile, home, health, and business. They are also known as claims examiners or claims consultants, and their main job is to process claims, negotiate settlements, verify insurance coverage, and review insurance cases.
Job Description
We are seeking a highly-analytical claims specialist to join our insurance department. Your main responsibilities will include reviewing client claims, determining what benefits they are eligible for, and providing professional testimony in court if needed.
While most of your work will be done in the office, there may be some travel required to conduct field visits, interviews, and research. The ideal candidate will be professional, analytical, and have a strong understanding of the latest insurance policies and regulations.
Job Duties and Responsibilities
- Analyze and investigate complex insurance claims to prevent fraud
- Conduct thorough site inspections
- Provide knowledgeable testimony in court, if necessary
- Review and process new claims and court verdicts
- Maintain relationships and communication with insurance departments and clients
- Develop and present claim review plans
- Negotiate settlements
- Resolve claims in a timely manner
- Stay up-to-date on insurance laws and regulations
Requirements and Qualifications
- High school diploma or equivalent
- At least 3 years of experience in a similar position
- Strong analytical and organizational skills
- Excellent knowledge of local, state, and federal insurance policies
- Great interpersonal and communication abilities
- Understanding of claims negotiation and settlement techniques
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