Claims Clerk reviews insurance claim forms and supporting documents for completeness and accuracy and obtains missing information as necessary. Inputs claim information into system for processing. Being a Claims Clerk verifies coverage eligibility. Calculates settlement amounts according to guidelines. Additionally, Claims Clerk processes routine claim payments. Requires a high school diploma or equivalent. Typically reports to a supervisor. The Claims Clerk works under the close direction of senior personnel in the functional area. Possesses a moderate understanding of general aspects of the job. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)
Description
Position Summary:
Looking for a detail-oriented, proactive individual with a passion for assisting clients and ensuring their peace of mind during challenging times. In this role, you will play a pivotal part in facilitating the claims process, providing exemplary service to our clients, and acting as a liaison between our agency, our clients, and our insurance carriers.
As a Claims Analyst, your responsibilities will include:
Promptly reporting loss information to the appropriate insurance company upon receipt.
Delivering courteous, same-day service to clients, advising them on loss settlement processes.
Vigilantly following up with insurance companies to ensure timely and accurate loss settlements.
Responding to customer inquiries within 24 hours, addressing their questions about loss statuses.
Adhering to established systems, procedures, and insurance company regulations.
Generating regular claim reports for management as needed.
Monitoring reserves and closing amounts with carriers on a regular basis.
Notifying relevant parties of severe losses or reserves exceeding $25,000.
Managing the maintenance of loss history, including recording payments and claim closures.
Coordinating activities between clients and claims adjusters as necessary.
Cultivating relationships with claims managers and supervisors from represented carriers.
Ensuring timely forwarding of legal notices to appropriate company personnel.
Extending courtesy and assistance to third parties reporting claims.
Documenting all significant conversations related to exposures and coverages.
Performing additional duties as assigned by management.
Requirements
To succeed in this role, you should possess:
Self-starter mentality with excellent verbal and written communication skills.
A comprehensive understanding of insurance coverages and claims procedures.
Proficiency in using personal computers, including Microsoft Word and Excel.
College education or equivalent insurance experience recommended.
California Claims knowledge or experience (preferred)
Workers' compensation knowledge is a plus.
Physical Demands and Work Environment:
Fast-paced, multi-tasking environment.
Extended periods of sitting at a desk and working on a computer.
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