Claims Specialist Job Description Template

The Claims Specialist is responsible for investigating and resolving property and casualty insurance claims. They will work closely with claimants, policyholders, agents, and other insurance companies to ensure that all parties are satisfied with the claim resolution. The Claims Specialist must be detail-oriented and have excellent customer service skills.

Claims Specialist Job Responsibilities

  • Review and process insurance claims in a timely and accurate manner
  • Investigate and resolve complex claim issues
  • Maintain detailed records of all claims activity
  • Communicate regularly with policyholders, claimants, and insurance carriers
  • Prepare reports on claim trends and loss analysis
  • Assist in the development and implementation ofClaims policies and procedures
  • Stay up to date on industry changes and developments


  • To adjudicate health insurance claims in a timely and accurate manner
  • To ensure that all claim payments are made in accordance with the terms of the policy
  • To investigate and resolve complex claim issues
  • To provide excellent customer service to policyholders and providers
  • To maintain up-to-date knowledge of health insurance policies and regulations

Claims Specialist Job Skills & Qualifications Needed

  • The skills and qualifications needed for the role of Claims Specialist vary depending on the specific position and company. However, most claims specialists will need at least a bachelor's degree in business, insurance, or a related field. They must also have strong communication and negotiation skills. Additionally, claims specialists should be detailoriented and able to work well under pressure.