Our Claims Specialist job description includes the responsibilities, duties, skills, education, qualifications, and experience.
About the Claims Specialist role
A Claims Specialist is responsible for managing and processing insurance claims. They investigate claims, assess damages, investigate fraud, and resolve disputes. They also may help customers with filing their claims and provide advice on how to manage their insurance policies.
Role Purpose
The purpose of a Claims Specialist is to provide administrative and technical support to insurance companies and other organizations in the processing of claims. The job role involves gathering and analyzing information to determine the validity of claims, and to determine the eligibility of claimants for benefits. Claims Specialists may also be responsible for maintaining accurate records of claims, producing reports and making recommendations to management regarding the best course of action. They may also provide customer service and answer questions related to the claims process.
Claims Specialist Summary
Claims Specialist Job Summary
The Claims Specialist is responsible for providing excellent customer service while processing and managing claims for customers. This role involves accurately gathering, reviewing, and verifying customer information and documents, and entering claims data into the company’s software system. The Claims Specialist must have excellent communication and multitasking skills, as well as a thorough understanding of the company’s claims process. This position requires excellent problem-solving skills and the ability to accurately assess customer needs. The Claims Specialist will work closely with other departments in order to provide timely and accurate service to customers.
Claims Specialist Duties
- Investigate and evaluate claims
- Analyze claim documents to determine coverage and liability
- Negotiate claim settlements
- Resolve disputes and litigation
- Provide customer service to claimants
- Ensure compliance with applicable laws and regulations
Claims Specialist Skills
- Excellent communication and interpersonal skills
- Ability to work independently and as part of a team
- Attention to detail
- Strong analytical and problem-solving skills
- Knowledge of relevant laws and regulations
Claims Specialist Requirements
- Excellent customer service skills
- Experience with insurance claims
- Proficiency in computer systems
- Ability to work independently
Personal Traits
- Strong analytical and problem-solving skills
- Attention to detail
- Excellent written and verbal communication
- Able to work independently and as part of a team
- Good organizational skills
- Ability to multi-task