What does a Claim Specialist do?
Published 3 min read
A claim specialist is responsible for investigating, evaluating, and settling insurance claims. They work with policyholders, claimants, and witnesses to gather information and determine the extent of the insurer’s liability. Claim specialists also negotiate settlements and resolve disputes.
Claim Specialist job duties include:
- Investigate and evaluate insurance claims
- Interview claimants and witnesses to determine facts of loss
- Examine police reports, medical reports, and other documents to determine coverage
- Determine if claims are valid and if so, how much the insurer should pay
- Negotiate settlements with claimants
- Prepare reports detailing findings
- Keep records of claim activity
- May testify in court on behalf of the insurer
- Some claims specialists work in fraud units and investigate suspicious claims
Claim Specialist Job Requirements
A Claim Specialist is responsible for investigating and processing insurance claims. They must have a high school diploma or equivalent, and some positions may require postsecondary education, such as an Associate's degree in insurance or business administration. Many Claim Specialists complete certification programs offered by professional organizations, such as the National Association of Insurance Adjusters. Some Claim Specialist positions may require one or more years of experience handling insurance claims.
Claim Specialist Skills
- Analytical skills
- Communication skills
- Organizational skills
- Research skills
- Writing skills
- Problem-solving skills
- Critical thinking skills
- Interpersonal skills
- Negotiation skills
- Mediation skills
- Conflict resolution skills
Related: Top Claim Specialist Skills: Definition and Examples
How to become a Claim Specialist
A Claim Specialist is a professional who investigates and processes insurance claims. They are responsible for determining the cause of the loss, evaluating the damage, and negotiating a settlement with the insurance company. A Claim Specialist must have strong communication and negotiation skills in order to be successful in this role.
To become a Claim Specialist, you will need to obtain a bachelor’s degree in business or a related field. Many Claim Specialists also have a law degree or designation such as Chartered Insurance Professional (CIP). Once you have obtained your education, you will need to obtain work experience in the insurance industry. Many Claim Specialists start their careers as adjusters or underwriters before moving into claims.
If you are interested in becoming a Claim Specialist, contact your local insurance companies and ask about job openings. You can also search online job boards or attend insurance job fairs.
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