Claims Professional I: Investigate & Resolve Insurance Claims

CRC Group; Flower Mound (TX); On-site; USD 42,000 - 65,000; Full time

Benefits offered by this job

Health insurance

401(k) plan with company match

Paid time off

New parent leave

Restricted stock units

Job summary

CRC Group is seeking a Claims Professional I to process and manage insurance claims with attention to policy language and coverage. You will investigate claims, document activities, and communicate with policyholders and agents to gather information, ensuring timely, fair resolutions.

The role emphasizes accurate data entry, regulatory compliance, and strong customer service. A bachelor’s degree in a related field and up to 2 years of claims experience are expected.

Qualifications

• Bachelor’s degree or equivalent practical experience in insurance, risk management, or related field.
• 0–2 years of experience in claims handling, insurance operations, or related role.
• Familiarity with insurance policies, terminology, and claims processing systems.

Responsibilities

• Investigate and evaluate insurance claims to determine coverage and liability.
• Review and interpret policy language and relevant documentation to assess claim validity.
• Communicate with policyholders, agents, and external parties to gather required information.
• Document all claim-related activities accurately in the system for record-keeping and regulatory compliance.
• Negotiate settlements within established authority and elevate complex cases when necessary.
• Provide exceptional customer service and maintain strong relationships with stakeholders.
• Ensure compliance with state regulations and company procedures throughout the claims process.

Skills

Claims investigation and analysis

Policy interpretation

Negotiation and resolution skills

Regulatory compliance

Data entry and documentation accuracy

Customer service orientation

Time management

Written and verbal communication

Education

Bachelor’s degree or equivalent practical experience in insurance/risk management

Job description

CRC Group is seeking a Claims Professional I to process and manage insurance claims with attention to policy language and coverage. You will investigate claims, document activities, and communicate with policyholders and agents to gather information, ensuring timely, fair resolutions.

The role emphasizes accurate data entry, regulatory compliance, and strong customer service. A bachelor’s degree in a related field and up to 2 years of claims experience are expected.