Claims- Clerk

Fred Loya Insurance Agency; El Paso (TX); On-site; USD 38,000 - 52,000; Full time

Job summary

Fred Loya Insurance Agency in El Paso, TX is seeking a Claims Processor to handle clerical data entry, medical information input, and claims reporting.

You will interpret policies and traffic laws to determine coverage, assist customers, and guide them through the claims process while ensuring accuracy and regulatory compliance.

Candidates should be organized, able to work independently, and have licensing or be pursuing P&C licensure; a high school diploma is preferred.

Qualifications

• Meet state licensing requirements
• Be able to work flexible hours
• Have the ability to work independently
• Excellent organization skills
• High school diploma or college preferred
• Must speak clearly and professionally

Responsibilities

• Process and document information in claims system from sources such as incoming letters and phone calls.
• Input medical information to claims system.
• Run claims related reports and other reports as needed.
• Interpret the insurance policy and determine if coverage is afforded.
• Interpret the traffic laws according to the state and city where the accident occurred and determine if the insured contributed.
• Provide customer service to internal and external customers.
• Guide the customer through the claims process.
• Identify potential fraud indicators.
• Secure statements, identify exposures, and reserve accordingly.
• Handle conflict resolution.
• Review estimates and damages being claimed.

Skills

Customer service

Communication skills

Organizational skills

Independent work

Licensing knowledge

Education

P&C Licensed

High school diploma

Job description

• Process and document information in claims system from sources such as incoming letters and phone calls;
• Input medical information to claims system;
• Run claims related reports and other reports as needed;
• Interpret the insurance policy and determine if coverage is afforded.
• Interpret the traffic laws according to the state, city where accident took place and determine if insured contributed to the accident.
• Offer customer service to both our internal and external customer.
• Explore, analyze and evaluate information
• Guide customer through the claims process.
• Identify potential fraud indicators
• Secure statements, identify exposures, and reserve accordingly.
• Other duties as assigned by management or as needed.

Essential Duties and Responsibilities

• Perform a variety of clerical duties;
• Process and document information in claims system from sources such as incoming letters and phone calls;
• Input medical information to claims system;
• Run claims related reports and other reports as needed;
• Interpret the insurance policy and determine if coverage is afforded.
• Interpret the traffic laws according to the state, city where accident took place and determine if insured contributed to the accident.
• Offer customer service to both our internal and external customer.
• Explore, analyze and evaluate information
• Guide customer through the claims process.
• Handle conflict resolution
• Review estimates/damages being claimed
• Identify potential fraud indicators
• Secure statements, identify exposures, and reserve accordingly.
• Other duties as assigned by management or as needed.

Qualifications/Requirements

• Meet state licensing requirements
• Be able to work flexible hours
• Have the ability to work independently
• Excellent organization skills
• High school diploma or college preferred
• Must speak clearly and professionally

Education/Training/Experience

• Insurance related experience preferred
• P&C Licensed