Claims Administration Representative

Jobtailor; California (MO); On-site; USD 65,000 - 95,000; Full time

Job summary

Jobtailor is seeking an experienced Insurance Claims Professional to join our team in the United States. You will review, validate, and process FNOL submissions, while supporting claim and account inquiries and resolving routine issues.

You will maintain accurate claim files, monitor activity, and prepare reports on trends, aging, and reserve movements. Collaborating with adjusters, carriers, and internal teams, you will escalate complex issues and ensure timely resolutions, adhering to

Qualifications

• 2+ years of insurance claims handling experience.
• Strong understanding of insurance principles and claims lifecycle.
• Ability to manage a portfolio of claims and meet deadlines.

Responsibilities

• Review, validate, and process FNOL submissions.
• Support claim and account inquiries and resolve routine issues.
• Maintain accurate claim files and records for compliance.
• Monitor claim activity and prepare reports on trends and aging.
• Coordinate with adjusters, carriers, brokers, and internal teams to facilitate claim progression.
• Identify and escalate complex claim issues and financial discrepancies.
• Respond to urgent requests and high-priority matters.
• Support claims projects and process improvements.
• Adhere to regulatory requirements and internal controls.
• Build relationships with clients, carriers, and partners.

Skills

Analytical thinking

Problem-solving

Communication skills

Detail-oriented

Multitasking

Tools

Applied Epic

Excel

Word

PowerPoint

Job description

• Review, validate, and process First Notice of Loss (FNOL) submissions
• Provide support for claim and account-related inquiries and resolve routine issues
• Maintain accurate claim files, documentation, and records for compliance, audit readiness, and claim management
• Monitor claim activity and milestones and prepare reports and status updates on claim trends, aging, reserve movements, and outstanding issues
• Coordinate with adjusters, carriers, brokers, and internal teams to facilitate claim progression and timely resolution
• Identify, investigate, and elevate complex claim issues, coverage questions, service concerns, and financial discrepancies
• Respond to urgent requests and high-priority claim matters
• Support claims projects, process improvements, and operational activities
• Adhere to claims handling procedures, regulatory requirements, and internal controls
• Build and maintain relationships with clients, carriers, and internal business partners
• Support Private Client and Health & Benefits stakeholders
• Maintain system records and deliver accounting operations, KPI reporting, and management information
• Use data-driven insights to prioritize execution, identify escalations, and communicate through data storytelling
• Support assigned initiatives and cross-functional projects
• Perform account reconciliations with markets and clients and resolve discrepancies
• Stay informed of legal, regulatory, and market changes affecting the role and business

Requirements

• 2+ years of insurance claims handling experience, preferably within a brokerage or agency environment
• Strong understanding of insurance principles, policy coverage, and the end-to-end claims lifecycle
• Ability to independently manage a portfolio of claims, prioritize competing demands, and make sound decisions in a fast-paced environment
• Excellent analytical, problem-solving, and investigative skills
• Strong interpersonal, verbal, and written communication skills
• Highly organized and detail-oriented, with ability to manage multiple priorities, meet deadlines, and ensure accurate documentation and recordkeeping
• Ability to interpret and apply policies, procedures, regulatory requirements, and internal controls
• Commercially minded and results-oriented, with a proactive and solution-focused approach
• Experience collaborating across claims, finance, operations, and external partners; offshore team experience is a plus
• Ability to mentor, support, and share knowledge with less experienced team members
• Self-motivated team player committed to continuous improvement and high-quality outcomes
• Proficiency with agency management systems; Applied Epic experience preferred
• Proficiency with Microsoft Office applications, particularly Excel, Word, and PowerPoint
• Flexibility to work 10:00 AM–6:00 PM EST hours to accommodate West Coast clients

Core Competencies

Demonstrates expertise in insurance claims handling, including FNOL processing, compliance, and documentation management. Proficient in analytical problem-solving and effective communication, with a strong focus on client relationships and operational efficiency.

Highest-signal resume keywords

• Insurance Claims Handling Experience
• Understanding of Insurance Principles
• Proficiency with Agency Management Systems
• Analytical and Problem-Solving Skills
• Strong Interpersonal and Communication Skills

Hard Skills

• Claims Lifecycle Management
• Data Analysis
• Account Reconciliation
• Regulatory Compliance
• Documentation Management

Soft Skills

• Highly Organized
• Detail-Oriented
• Self-Motivated Team Player
• Proactive and Solution-Focused
• Ability to Mentor and Support Team Members

Industry Keywords

• First Notice of Loss (FNOL)
• Claims Processing
• Client Relationship Management
• Operational Activities
• Cross-Functional Collaboration

Tools & Technologies

• Applied Epic
• Microsoft Excel
• Microsoft Word
• Microsoft PowerPoint