Insurance Claims Associate (225-1015)

An Insurance Claims Associate is a critical position in the insurance industry, responsible for ensuring that all claims are processed efficiently and accurately. These associates act as the primary point of contact for policyholders who have suffered a loss or need to file a claim. They play a vital role in assessing the validity of claims, coordinating with various internal and external stakeholders such as loss adjusters, legal teams, and policyholders, and ensuring a fair settlement is reached in a timely manner. A position in this role requires strong analytical skills, excellent customer service abilities, and a comprehensive understanding of insurance policies and procedures. By maintaining a high level of accuracy and integrity, the Insurance Claims Associate helps insurance companies minimize losses while maximizing customer satisfaction.

Responsibilities

• Review insurance claims to determine coverage and liability issues.
• Communicate effectively with policyholders to gather necessary claim information.
• Coordinate with field adjusters for thorough inspection and assessment of claims.
• Evaluate the validity of claims through detailed investigation and analysis.
• Authorize claim payments within a designated authority level and guidelines.
• Document claim details accurately using the company's management system.
• Provide excellent customer service to ensure policyholder satisfaction and retention.
• Maintain knowledge of industry developments and changes in insurance regulations.
• Collaborate with legal and fraud units to address potential fraudulent claims.
• Negotiate settlements with claimants to resolve claims amicably and efficiently.
• Prepare detailed reports and summary findings for senior management reviews.
• Ensure compliance with all state and federal insurance regulations and laws.

Requirements

• Bachelor’s degree in Insurance, Business, or related field is preferred.
• Minimum of two years experience in the insurance claims processing industry.
• Strong analytical and problem-solving skills with attention to detail.
• Excellent verbal and written communication abilities for handling claims efficiently.
• Proven track record in delivering outstanding customer service experiences.
• Ability to work independently, manage multiple tasks, and meet tight deadlines.
• Proficiency in using claims management software and Microsoft Office Suite.