Claims Specialist: Fast, Detail-Driven Resolution

Marketing - 316; United States; On-site; USD 60,000 - 85,000; Full time

Job summary

Cover Genius in the United States is seeking a Claims Specialist to assess and settle claims within designated authority, ensuring timely processing and accurate queue management. The role emphasizes attention to detail, organization, and ownership.

You will review claims via the XClaim platform, collaborate with Support, Content and Complaints teams to meet SLAs and NPS, and uphold insurance guidelines and regulatory requirements.

Qualifications

• 0–2 years experience handling customer queries online, ideally with litigations.
• Active U.S. state Adjuster License in good standing (multi-state or reciprocal licenses preferred).
• Fluency in English (verbal & written); any additional language is a plus for external communications.
• Basic understanding of insurance products and terminology.
• Collaborative mindset with ability to guide junior or non-licensed team members.

Responsibilities

• Claims Processing: Manage day-to-day claims activities for new claims, including claims actions, emails, and payments.
• Ownership: Own the assessment and approval of new claims within the authority and fraud thresholds.
• Customer Communication: Handle inquiries regarding claims status and policy coverage via chat, phone or email.
• Documentation: Ensure all necessary documentation is collected and filed accurately in the system.
• Quality: Maintain quality to meet KPIs and SLAs.
• Collaboration: Communicate with Claims, Support and other teams to resolve claims efficiently.
• Compliance: Be aware of current insurance guidelines and regulations.
• Process Improvement: Identify and recommend improvements to enhance handling efficiency.

Skills

Customer queries

Adjuster license

English fluency

Insurance terms

Collaboration

Education

Bachelor’s or postgraduate degree

Job description

Cover Genius in the United States is seeking a Claims Specialist to assess and settle claims within designated authority, ensuring timely processing and accurate queue management. The role emphasizes attention to detail, organization, and ownership.

You will review claims via the XClaim platform, collaborate with Support, Content and Complaints teams to meet SLAs and NPS, and uphold insurance guidelines and regulatory requirements.