How to Become a Claims Representative

Life, health, and property insurance companies require highly trained professionals to process and review claims to make sure the guidelines are followed and the costs are rational. This is the job of claims representatives.

What does a claims representative do?

Claims representatives are responsible for processing and reviewing claims requests. They ensure all the guidelines are adhered by and that the costs of the claim are reasonable. They review policies and determine if claims are covered. They authorize or deny claims or send them to other claims professionals for further analysis. Claims representatives gather the necessary information from clients and fill out the required paperwork. They often speak to clients on the phone and ask them important questions regarding the claim. They also provide customer services and resolve any issues related to claims.

What kind of training does a claims representative need?

Claims representatives typically need at least a high school diploma or GED, but most employers prefer applicants with college degree. Many aspiring claims representatives complete internships to gain practical experience in the field. Most employers provide some on the job training to enable new representatives to learn the necessary policies and procedures. Many employers require claims representatives to pass many written aptitude tests that measure mathematical, analytical, and communication skills. Some states require claims representatives to be licensed. Licensing requirements vary by typically include minimum experience and passing a written examination. Claims representatives must complete regular continuing education and additional training to maintain their licenses, keep their skills up to date, and stay abreast with advancements in the field.

What are the prospects for a career as a claims representative?

Employment of claims representatives is expected to grow as fast as average for all professions, increasing 7% from 2008 to 2018 (1). The growing population and increase in a variety of insurance claims will drive job growth.

Job prospects should be good with strong competition. Claims representatives with advanced training and extensive experience will have the best job opportunities. Some job openings will stem from the need to replace claims representatives that retire, transfer, or leave the field for other reasons.

How much do claims representatives make?

As of April 2010, claims representatives with less than 1 year experience earn average annual salaries between $30,863 and $39,576. Those with 1 to 4 years experience earn annual salaries between $35,775 and $46,429 (2).

A career as a claims representative is a great choice for individuals with a strong interest in processing and reviewing a variety of insurance claims. Claims representatives must have a solid understanding of the policies and procedures related to insurance claims. Mathematical aptitude, good deductive reasoning skills, critical thinking, and good organizational skills are necessary characteristics. Claims representatives must have good communication and interpersonal skills and great customer service skills. They must be able to work under stress and pressure and have the ability to handle intense situations.

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