Insurance Claims Representative

Job Description

Job Description

Job Title : Claims Representative

The Claims Representative is responsible for managing and resolving insurance claims efficiently, fairly, and in compliance with company policies and state regulations. This role serves as the primary point of contact for policyholders and other stakeholders throughout the claims process, ensuring exceptional customer service and accurate documentation.

Key Responsibilities

• Investigate and Maintain Claims : Collect and review accident reports, statements, photos, estimates, and other documentation to determine claim validity.
• Evaluate Coverage and Liability : Analyze policy terms, assess damages, and determine liability based on evidence and applicable regulations.
• Communicate with Stakeholders : Provide timely updates and clear explanations to policyholders, agents, attorneys, and other involved parties via phone, email, and written correspondence.
• Negotiate Settlements : Work with claimants or representatives to reach fair settlements within policy limits and company guidelines.
• Document and Report : Maintain accurate records of all communications, investigations, and decisions for compliance and audit purposes.
• Collaborate Across Departments : Partner with legal, underwriting, and special investigation units on complex claims.
• Ensure Regulatory Compliance : Stay current on state-specific handling requirements and industry best practices.
• Deliver Exceptional Customer Service : Demonstrate empathy and professionalism to maintain trust and satisfaction throughout the claims process.

Qualifications

Education & Experience

Skills & Competencies

Preferred Certifications

Pay Details : $28.84 to $33.65 per hour

Search managed by : Gerald Morales

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer / Veterans / Disabled

Military connected talent encouraged to apply

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https : / / www- uat.lhh.com / us / en / candidate -privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and / or security clearance requirements, including, as applicable :

Massachusetts Candidates Only : It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.