Claims Specialist

About the role

The Claims Specialist is responsible for providing prompt, effective assistance to clients and third parties reporting and settling claims with the agency. They also act as a liaison between the agency and carriers and assist others in the agency with service regarding claims activity.

Responsibilities

• Reports loss/claim information to the appropriate carrier the same day it is received.
• Gives prompt and courteous service on a same‑day basis to all clients.
• Takes first reports of claims.
• Organizes claim information on forms and submits claim to appropriate carrier.
• Sets expectations of the claim process including time frames, deductibles, restoration companies and adjustors.
• Follows up with insurance companies for the timely and accurate settlement of losses.
• Responds to customers’ inquiries and questions regarding the status of loss within 24 hours of inquiry.
• Follows all systems, procedures, and insurance company regulations.
• Authorizes claim payments within agency authority.
• Coordinates, as necessary, any activities between clients and claim adjusters.
• Completes weekly and monthly reports of claims notifications and updates.
• Notifies risk advisor and/or management of severe losses over $100,000.
• Provides updates to management and/or appropriate risk advisor/customer service for clients with severe or frequent losses.
• Deals promptly and with full integrity with all carrier claims personnel, responding within 24 hours to any request for action or information.

Requirements

• Extensive knowledge of claims procedures and insurance coverage.
• Ability to satisfy the needs of the customer, both internal and external, with little assistance from others.
• Strong negotiating, decision‑making, and relationship‑building skills.
• Excellent customer service and teamwork skills.
• Ability to interact with employees, customers and vendor companies.
• Working knowledge of computer software packages including Microsoft Word, Excel and Outlook.
• Ability to use general office equipment, including a computer, calculator, typewriter, fax machine, copier and telephone.
• Ability to learn and perform new duties and responsibilities.
• High school diploma required; Bachelor’s degree preferred.
• Must be willing to work toward industry designations.
• Requires a current driver’s license.
• General office work environment; regular use of arms, hands, and fingers; frequent sitting, reaching, standing, walking, stooping, talking and hearing; ability to lift/move up to 10 pounds.
• Ability to work during regular business hours (8:00 am‑5:00 pm); travel as needed.
• May have access to Protected Health Information (PHI) and Electronic Protected Health Information (ePHI); must follow HIPAA Confidentiality Agreement guidelines.

Schedule

Regular business hours: 8:00 am to 5:00 pm, with travel as needed.