Claims Specialist

Responsibilities

• Evaluate and process insurance claims.
• Review documentation, investigate claims, and determine coverage and settlement amounts.
• Communicate with policyholders, insurance agents, and other parties involved to gather necessary information and resolve any issues.
• Ensure compliance with insurance regulations and company policies.
• Manage open claim file inventory to ensure timely resolution of cases.
• Provide excellent customer service to internal and external customers.
• Work effectively with both internal and external counsel on litigated claims.
• Determine and set claim reserves based on the current fact pattern of the claim.

Qualifications

• 2 years college or specialized training (Business/Accounting/Related field)
• 3+ years of experience in a similar role
• Strong verbal and written communication, negotiation, organization, and analytical skills
• Proficient in Microsoft Excel, Word, and Access
• Industry training (AIC, CPCU, etc.)
• Proficient in RMIS systems for generating reports
• Negotiation skills for claims settlement process
• Claims management experience
• Ability to work independently and as part of a team