Claims advisor Job Description

Claims advisor Job Description Template

Claims Advisors manage insurance claims, assessing the validity of the claim, negotiating settlements, and ensuring prompt and fair resolution. Responsibilities include liaising with claimants, insurers, and legal professionals.

Responsibilities:

  • Assess and process claims accurately and in a timely manner
  • Investigate and gather information to make informed decisions
  • Communicate with customers, insurance companies, and other parties involved in the claim process
  • Negotiate settlements and explain the claims process to customers
  • Update claim records and report on claim status to relevant parties
  • Ensure compliance with regulatory and company standards
  • Provide exceptional customer service and support
  • Identify and escalate complex or high-risk claims to senior staff or management

Requirements:

  • Excellent communication skills, both verbal and written, to effectively interact with customers and colleagues.
  • Strong analytical and problem-solving skills to investigate and resolve claims and disputes.
  • Ability to work in a fast-paced environment, prioritize tasks, and meet deadlines while maintaining accuracy and attention to detail.
  • Knowledge of insurance policies and regulations to ensure compliance with industry standards and internal policies.
  • Proficiency in using computer systems and software applications to process claims, generate reports, and maintain records.
  • Customer-focused mindset to ensure a positive experience for customers throughout the claims process.
  • Ability to work independently as well as in a team environment, collaborating with colleagues to achieve departmental goals.
  • Flexibility to adapt to changes in processes, procedures, and priorities as the business evolves.