Insurance Claims Specialists

Job Description

Job Description

Description :

Reports To : Sr. Director of Corporate Safety

Job Summary

The Insurance Claims Specialist will manage and process various types of insurance claims, including property, cargo, workers' compensation, and vehicle claims.

The role involves reviewing claims, submitting claims, and working closely with internal teams, clients, and insurers to ensure prompt and fair resolution.

This individual must demonstrate a high degree of professionalism, attention to detail, and a customer-focused attitude to resolve claims efficiently while minimizing company liability.

Key Roles and Responsibilities

Claims Management :

• Handle all stages of claims processing for property, cargo, workers' compensation, and vehicle-related incidents.
• Review claim documentation to ensure accuracy and completeness.
• Investigate and evaluate the legitimacy and extent of claims by gathering relevant evidence such as photographs, witness statements, police reports, and damage assessments.
• Coordinate and communicate with insurance carriers, clients, and third-party adjusters to settle claims.
• Determine the coverage and liability according to insurance limits.
• Monitor the progress of claims to ensure timely resolution.

Client and Stakeholder Communication :

• Act as the main point of contact for clients and stakeholders throughout the claims process.
• Provide clear and timely updates regarding the status of claims.
• Assist clients with completing claims forms and advise on claim procedures.

Data Management and Reporting :

• Maintain detailed records of all claims activities, correspondence, and outcomes in the company’s claims management system.
• Prepare reports summarizing claim details, settlements, and trends for management review.
• Ensure compliance with all legal and regulatory requirements related to claims handling.

Risk Mitigation and Process Improvement :

• Identify trends in claims that indicate potential operational risks or areas for improvement.
• Suggest process enhancements to prevent future incidents and reduce claims frequency or severity.

Compliance :

• Ensure all claims are handled in accordance with company policies, procedures, and industry regulations.
• Stay informed on the latest insurance industry regulations and legal precedents related to claims handling.

Competency Requirements

• Detail-Oriented : Meticulous attention to detail to ensure all documentation and claim assessments are accurate.
• Analytical Thinking : Ability to analyze complex situations, evaluate liability, and make sound judgments on claim outcomes.
• Problem-Solving : Proficiency in resolving issues and settlements effectively.
• Communication : Strong verbal and written communication skills to explain policies, processes, and claim outcomes to clients and stakeholders.
• Time Management : Ability to handle multiple claims simultaneously and meet deadlines.
• Empathy and Professionalism : Ability to manage sensitive situations with tact and maintain professionalism under pressure.

Qualifications / Knowledge / Skills / Experience

Experience :

• Minimum of 3-5 years of experience handling insurance claims, preferably across multiple types (e.g., property, cargo, vehicle, workers' compensation).
• Proven track record of settling claims within company guidelines and maintaining high customer satisfaction.
• Familiarity with claim investigation processes, including knowledge of legal and medical terminology as related to claims.

Knowledge :

• Strong understanding of insurance policies, coverage, and exclusions.
• Working knowledge of insurance industry laws, regulations, and best practices.
• Familiarity with claims management systems and software tools (e.g., Guidewire, ClaimXperience, or similar).
• Skills :
• Proficiency with Microsoft Office Suite (Word, Excel, Outlook) and claims management software.
• Strong interpersonal skills.
• Excellent organizational and administrative skills.

Work Environment

Office-based role with potential for remote work flexibility depending on company policy.

Requirements :

Required Education / Training

Education :

• Bachelor’s degree in Insurance, Business Administration, Risk Management, or a related field is preferred. Equivalent experience will be considered.
• Certification in claims management or insurance (e.g., AIC, CPCU) is a plus.

Training :

Ongoing training and professional development in insurance law, claims handling, and risk management.

Physical Requirements

• Ability to sit for extended periods while reviewing claims and conducting investigations.
9 days ago