What does a Claims Representative do?

Claims representatives work for insurance companies to settle claims through the evaluation of facts of a customer's situation surrounding their claim. They are responsible for determining whether the loss is covered and what compensation should be. They investigate thoroughly to ensure that an insurance claim is not fraudulent and may be required to contact relevant third-parties including a doctor, an employer, or to consult with a police report. Ultimately, claims representatives negotiate insurance settlements, authorize payments, and keep records.

Claims representatives serve as the liaison between a policyholder and an insurance specialist and are often the initial point person for insurance-related events. In some instances, they collaborate with representatives from other insurance companies for an incident that is relevant to both industries, including medical and automotive carriers. Claims representatives need a minimum high school diploma or GED and complete a college degree program that provides academic training for the vocation. Professional certification is also available.

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Average Years of Experience

0 - 1
21%
2 - 4
36%
5 - 7
4%
8+
39%

Common Skill Sets

Excellent Customer Service
Microsoft Office Suite
Written Communication
Excellent Communication
Outlook
Powerpoint
Coding
Writing

Claims Representative Seniority Levels

Claims Analyst
17% made the transition
Claims Adjuster
45% made the transition
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Claims Representative Salaries

Average Base Pay

$47,564 /yr
Same as national average
Not including cash compensation
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$33K
Median: $48K
$70K
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Glassdoor Estimated Salary

Claims Representative Jobs