Claims Representative, Medical Only

Jobtailor; Baton Rouge (LA); On-site; USD 55,000 - 75,000; Full time

Job summary

Jobtailor seeks a skilled claims professional to manage property and casualty claims, assess coverage and liability, and negotiate settlements within authority. The role requires strong analytical and negotiation abilities, effective communication, and meticulous file maintenance.

Experience in claims handling and knowledge of industry laws support timely resolutions and compliant practices. The position emphasizes relationship-building with insureds and external partners, along with discretion

Qualifications

• Bachelor’s degree or equivalent experience in a related field.
• Minimum of 6 months of property and casualty claims handling experience.
• AIC designation or progress toward it preferred.
• Ability to work within limits and authority on moderately technically complex assignments.
• Strong analytical, negotiation, and problem-solving skills.
• Knowledge of insurance policies, coverage, and claims handling procedures.
• Familiarity with industry laws and regulations.
• Ability to organize and prioritize caseloads for timely resolution.
• Excellent interpersonal and communication skills, including relationship-building and negotiation abilities.
• Discretion when handling confidential information.

Responsibilities

• Manage an inventory of claims to evaluate compensability and liability.
• Conduct claim investigations to confirm coverage and determine liability, compensability, and damages.
• Determine and potentially negotiate claim settlements and reserves within prescribed authority.
• Attend arbitrations, mediations, depositions, or trials as needed.
• Convey routine to moderately complex coverage and settlement information to insureds, claimants, and external partners.
• Authorize payments within assigned authority limits and ensure timely payment.
• Maintain accurate and detailed claim files, including correspondence, reports, and settlement agreements.
• Perform other duties as assigned.

Skills

Negotiation Skills

Analytical Skills

Communication Skills

Problem-Solving Skills

Relationship-Building

Discretion

Education

Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or related field

Associate in Claims (AIC)

Job description

• Manage an inventory of claims to evaluate compensability and liability
• Conduct claim investigations to confirm coverage and determine liability, compensability, and damages
• Determine and potentially negotiate claim settlements and reserves within prescribed authority
• Attend arbitrations, mediations, depositions, or trials as needed
• Convey routine to moderately complex coverage and settlement information to insureds, claimants, and external partners
• Authorize payments within assigned authority limits and ensure timely payment
• Maintain accurate and detailed claim files, including correspondence, reports, and settlement agreements
• Perform other duties as assigned

Requirements

• Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field, or equivalent experience
• Minimum of 6 months of experience in property and casualty claims handling
• Completion of or continuing progress toward a professional designation such as Associate in Claims (AIC) preferred
• Ability to work within specific limits and authority on assignments of moderate technical complexity and coordination
• Functional analytical, negotiation, and problem‑solving skills
• Knowledge of insurance policies, coverage, and claims handling procedures
• Knowledge of industry laws and regulations
• Ability to organize and prioritize caseloads to ensure timely claim resolution
• Strong interpersonal and communication skills, including relationship‑building and negotiation abilities
• Ability to handle confidential information with discretion

Core Competencies

Demonstrates expertise in claims management, including evaluating compensability, conducting investigations, and negotiating settlements. Proficient in maintaining detailed claim files and ensuring compliance with industry laws and regulations.

Highest-signal resume keywords

• Claims Handling
• Negotiation Skills
• Insurance Policies Knowledge
• Analytical Skills
• Bachelor's Degree in Business Administration

ATS Optimization Keywords

Hard Skills

• Claims Evaluation
• Liability Assessment
• Settlement Negotiation
• Claims Investigation
• Claims Resolution

Soft Skills

• Interpersonal Skills
• Communication Skills
• Problem‑Solving Skills
• Relationship‑Building
• Discretion

Certifications & Qualifications

• Associate in Claims (AIC)

Industry Keywords

• Property and Casualty Claims
• Insurance Coverage
• Claims Handling Procedures
• Industry Laws and Regulations