Claims Examiner Intermediate

In the Role

• Evaluate claims against eligibility requirements, provisions and applicable processes
• Enter and maintain accurate data in claims processing systems, including written correspondence
• Research and gather additional information to support claim decisions
• Perform benefit calculations and conduct claim investigations
• Communicate with internal and external customers via phone and written correspondence
• Maintain positive customer relationships through professional and empathetic interactions
• Participate in departmental meetings, training activities, and continuous improvement initiatives
• Support occasional special projects and other duties as assigned

Requirements

• High School diploma or equivalent required

• Minimum 2+ year of general work experience

• Strong analytical and problem-solving skills with attention to detail
• Ability to evaluate claims against eligibility requirements and interpret policy language
• Effective verbal and written communication skills
• Basic math skills and proficiency in a PC environment, including Microsoft Office
• Ability to build and maintain positive customer relationships
• 6 months or more of auto claims or auto insurance experience preferred