Claims Specialist Job Description Template

Claims specialist evaluating damaged vehicle

A claims specialist goes into action when a client files an insurance claim, like those made on a homeowner’s, health, or car insurance policy. The specialist reports and processes these claims by researching the policy and accumulating evidence regarding the claim. They then verify the coverage and help to determine the compensation or settlement.

This claims specialist job description template can help you create an effective job posting and find qualified candidates more efficiently. In addition, consider reviewing existing claims specialist job listings for more inspiration on what to include in your job description.

Claims specialist evaluating damaged vehicle

Claims Specialist

[Intro Paragraph] Including an introduction paragraph is a great way to sell your company and the open position to qualified candidates. Show interested readers what you bring to the table. To stand out, consider highlighting your work culture, your contribution as a green company, and your commitment to diversity.

Claims Specialist Job Responsibilities: The next part of your claims specialist job description should provide some information about the expected job responsibilities. For example, your position may require a specialist who:

  • Determines covered insurance losses by studying provisions of a policy or certificate.
  • Establishes proof of loss by studying documentation and assembling additional information from outside sources.
  • Documents specific claims by completing and recording forms, reports, logs, and records.
  • Analyzes insurance claims to prevent fraud.
  • Prepares reports by collecting, analyzing, and summarizing information.
  • Resolves claims by approving or denying documentation, calculating benefits due, and determining compensation settlement.
  • Ensures legal compliance by following company policies, procedures, and guidelines, as well as state and federal insurance regulations.
  • Maintains quality customer service by following customer services practices and responding to customer inquiries.
  • Provides legal support by assembling documentation for settlement action.
  • Protects operations by keeping claims information confidential.
  • Maintains a good relationship with insurance departments.

[Work Hours and Benefits] Mentioning the work hours and benefits should be the next part of your claims specialist job description. Tell potential candidates about the work schedule, and any possible overtime or seasonal work.

A talented claims specialist will have certain expectations when it comes down to the work benefits. Talk about any commissions, paid vacation time, dental and vision insurance coverage, or any other attractive benefits you may offer.

Claims Specialist Qualifications and Skills

  • Extensive knowledge of insurance-related policies and legislations
  • Proficient in analytical math
  • Excellent conflict resolution skills
  • Strong written communication skills

Education and Experience Requirements

  • A high school diploma or equivalent for entry-level
  • A bachelor’s degree in business and accounting
  • A minimum of [Number] years in a similar position

[Call to Action] Now that potential candidates are familiar with your company and the open position, you need to include a strong call to action that encourages readers to apply. Share the contact details of your hiring manager or provide a direct link to the hiring site. Be as detailed as possible so candidates know where to send their resumes.

Want to Ensure That Your Claims Specialist Job Description is Effective?

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