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.
Claims Representative Salaries
Average Base Pay
Claims Representative Career Path
Learn how to become a Claims Representative, what skills and education you need to succeed, and what level of pay to expect at each step on your career path.
Claims Representative Insights
“Salary was pretty good but not super competative but profit sharing one a year was nice perk”
“Great training and resources will be setup to do your job with confidence and continuous improvement.”
“we are told to do many things ourselves that are really tasks for support staff.”
“Very little information was ever communicated to me about when I could possibly get a better job.”
“I was given many opportunities to ask any questions and was always offered ways to communicate if I came up with questions later.”
“I worked my whole life in the service industry and this was my first opportunity to work a "9”
“I had to train others and was given no option not to and no pay incentive”
“Do not look at this as a career and you’ll be happy and healthy.”
Claims Representative Interviews
Claims Representative jobs
Frequently asked questions about the role and responsibilities of a claims representative
When working as a claims representative, the most common skills you will need to perform your job and for career success are Excellent Customer Service, Microsoft Office Suite, Written Communication, Excellent Communication and Outlook.
- Claims Analyst
- Claims Adjuster
- Claims Examiner
- Claims Manager
The most common qualifications to become a claims representative is a minimum of a Bachelor's Degree and an average of 0 - 1 of experience not including years spent in education and/or training.