We are hiring for a Customer Service Representative for a local insurance company. In this role you will be responsible for analyzing, reviewing, and processing insurance claims to ensure timely and accurate settlement in accordance with company policies, procedures, and regulatory guidelines. The role involves assessing claim validity, investigating facts, determining coverage, and negotiating settlements, while providing excellent customer service.

Key Responsibilities

• Communicate claim decisions and settlement offers clearly and professionally to claimants and stakeholders.
• Provide guidance and support to policyholders during the claims process.
• Review and analyze insurance claims to determine validity and coverage under existing policies.
• Ensure claims are processed accurately and in compliance with state and federal regulations.
• Conduct thorough investigations, including reviewing policy details, obtaining statements, and gathering evidence such as photos, police reports, and repair estimates.
• Collaborate with adjusters, appraisers, and other professionals to verify facts and assess damages.
• Evaluate claims to determine appropriate settlement amounts based on policy terms and loss conditions.
• Negotiate settlements with claimants, legal representatives, or third parties while maintaining fairness and adherence to company policies.

• Maintain accurate and detailed records of claims, correspondence, and decisions in the company’s claims management system.
• Prepare reports summarizing claim trends, issues, and recommendations for management.

Qualifications

Education : Bachelor’s degree in insurance, business administration, or a related field preferred.

Skills :

• Strong analytical and decision-making abilities.
• Excellent communication and negotiation skills.
• Proficiency with claims management software and Microsoft Office.
• Knowledge of state and federal insurance regulations.