CLAIMS ADMINISTRATOR JOB DESCRIPTION

Few back-office functions carry as much regulatory weight as insurance claims administration. A Claims Administrator in this field owns the processing of property, casualty, workers' compensation, or health benefit claims - verifying coverage, applying plan documents, and routing decisions within the authority limits defined by state workers' compensation statutes and, where applicable, DOI or FCA regulatory frameworks. Accuracy here is not a preference. An adjudicated claim that misapplies an ICD code or misreads a subrogation right can expose an organization to regulatory sanction, claimant litigation, or unrecoverable reserve errors.

As the Claims Administrator, you will process, investigate, and resolve insurance claims across property, casualty, or health lines within defined authority thresholds, ensuring each case is adjudicated accurately and closed within contractual SLA windows. You will operate within a dedicated claims or risk management team, coordinating directly with loss adjusters, insurance carriers, outside counsel, and internal departments to move cases from first notification of loss through final settlement.

Career Impact: Sustained experience adjudicating property, casualty, and workers' compensation claims under state regulatory frameworks builds the compliance credibility that supports progression toward senior adjuster or risk management designations such as AIC or ARM.

Business Impact: Accurate, timely claim resolution directly controls reserve exposure and subrogation recovery rates, protecting the organization's loss ratio and its relationships with insurance carriers.

Growth Opportunity: The analytical and regulatory depth this role requires, spanning coverage interpretation, litigation liaison, and SLA-driven caseload management, positions you for advancement into Claims Examiner, Claims Supervisor, or Risk Analyst roles.

• Investigate property, casualty, and workers' compensation claims by reviewing policy documents, loss adjuster reports, and claimant-submitted evidence to determine coverage and liability.
• Adjudicate claims within assigned authority limits, approving settlements, issuing denials, and escalating complex or litigated matters to senior staff or outside counsel.
• Coordinate with insurance carriers, third-party administrators, loss adjusters, and internal legal teams to progress each claim file through all required workflow stages.
• Monitor open caseloads against contractual SLA deadlines, generating status reports and escalating aging files before service thresholds are breached.
• Process settlement payments, subrogation recoveries, and reserve adjustments accurately, ensuring proper authorization and documentation at each transaction.
• Audit claim files for regulatory compliance with applicable state workers' compensation statutes, DOI requirements, and internal procedural controls.
• Identify and flag potentially fraudulent, duplicate, or irregular claims to the team leader or risk manager for further review.
• Maintain claim management systems with complete, current records including notes, decisions, payment history, and correspondence throughout the claim lifecycle.

• Bachelor's degree in Risk Management, Business, or a related field, or equivalent work experience.
• 3 or more years of insurance claims administration experience, with demonstrated responsibility for property, casualty, or workers' compensation claim files from first notification through closure.
• Working knowledge of coverage interpretation and policy contract analysis across at least one major line: property and casualty, workers' compensation, or health and welfare benefits.
• Familiarity with applicable regulatory frameworks, including state workers' compensation statutes, DOI claims handling requirements, or HIPAA and ICD/CPT coding standards where health claims are in scope.
• Proven ability to manage a high-volume caseload independently, prioritizing files against SLA deadlines and authority-limit thresholds with minimal supervision.
• Strong written and verbal communication skills, with demonstrated ability to correspond professionally with claimants, adjusters, carriers, and legal representatives.
• Sound analytical and organizational skills, with attention to detail in documenting decisions, reserves, and payment transactions accurately.

• Professional certification in claims or risk management, such as AIC or ARM, or active progress toward either designation.
• Prior experience liaising with outside legal counsel on litigated claims or subrogation recovery files.
• Exposure to workers' compensation regulations across multiple US states, or to DOI compliance requirements in a regulated insurance environment.
• Experience administering health and welfare benefit claims under FSA, HRA, or similar plan structures with HIPAA documentation requirements.

• Caseload closure rate within contractual SLA windows, reflecting timely resolution of assigned claim files.
• Reserve accuracy percentage, measuring how closely initial reserves align with final settlement values.
• Subrogation recovery rate, tracking dollars recovered against eligible claims in the managed portfolio.
• Denial overturn rate on appeal, indicating accuracy of initial coverage determinations.
• Audit compliance score on randomly selected files reviewed against procedural and regulatory controls.
• Typical tools: Claims management systems (commonly Guidewire, Applied Epic); office productivity (commonly Microsoft Excel, Outlook).

• Base Salary Range: $45,000 to $65,000 annually, varying by state regulatory scope and seniority
• Bonus: Annual performance bonus of 5 to 10 percent, tied to caseload and accuracy metrics
• Equity: Not typical at this level in insurance operations roles
• Health Benefits: Medical, dental, and vision coverage; employer contributes to premium
• PTO: 15 to 20 days annually, plus standard federal holidays
• Common Perks: Professional certification reimbursement for AIC or ARM, hybrid work schedule where available

Figures are estimates based on general US market benchmarks and may be outdated. Adjust based on location, company size, and seniority level.

Work authorization in the United States is required for this position. Employment is contingent on successful completion of a background check, which may include verification of prior claims handling experience and, where applicable, credit history review consistent with the responsibilities of this role. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, veteran status, or any other characteristic protected under applicable federal, state, and local law. Reasonable accommodations are available to individuals with disabilities throughout the application and employment process upon request.

The Claims Administrator owns the end-to-end claims adjudication process for dealers, service centers, and customers, including reviewing coverage, processing web portal submissions, and building the labor catalog from collected claim data. Working alongside Customer Service support personnel, this role delivers accurate and timely claim resolution that protects both customer relationships and operational standards.

Key Responsibilities

• Review and adjudicate customer claims according to the time frame detailed in the Dealer Operations Manual.
• Assist customers in navigating through the web portal to file claims, reporting aircraft and engine usage, and using the Illustrated Parts Catalog.
• Assist customers in identifying coverage for all products and services offered.
• Collect, document, and evaluate claim data to build and update the labor catalog.
• Interact with other Customer Service support personnel to achieve customer, operational, and business objectives.
• Attend customer service training as needed per Management.

Required Qualifications

• Associate degree in Business or aviation-related subject, or equivalent.
• 3-5 years of business, commercial aviation, or warranty administration experience in a similar industry.
• Customer service experience in the aviation, automobile, or luxury product industry.
• A&P license preferred or strong understanding of industry-standard Aircraft Maintenance practices.
• Experience in analyzing coverage term contracts.
• Proficient in SAP, Excel, Word, PowerPoint, and Visio.
• Excellent verbal and written communication skills.
• Multilingual skills are desired but not required.

Embedded within the claims team, the Claims Administrator investigates, evaluates, and resolves first-party, third-party, lien holder, and repo claims of minimal to moderate complexity against service, productivity, and quality standards. Working closely with insurers, claimants, repair facilities, and internal departments, this role enables prompt insurance settlement processing and consistent closure of outstanding claims.

Core Functions

• Investigate, evaluate, negotiate, and resolve claims of minimal to moderate complexity.
• Manage caseload to meet service, productivity, and quality standards.
• Investigate, appraise, and settle vehicle claims.
• Examine policies to determine coverage.
• Interview or correspond with claimants and witnesses, consult police or impound records, and inspect property damage to determine liability.
• Investigate possible reimbursement of applicable fees in the event of a repo or lien holder claim.

Qualifications & Experience

• High School Diploma or equivalent required; Associate degree preferred.
• Previous experience in the insurance claim industry preferred.
• Sound knowledge of applicable laws and regulations of the auto claim industry.
• Excellent written and oral communication skills for reports, interviews, and negotiations.
• Ability to work in a high-volume, fast-paced environment, including evenings and weekends as needed.
• Strong motivation, organizational skills, and ability to work independently and as part of a team.

Reporting to departmental management, the Claims Administrator processes claims end-to-end in accordance with the claims OPM while maintaining up-to-date records across company systems and ensuring compliance with all applicable Group and Company policies, legal requirements, and regulatory standards. Partnering with divisional teams and stakeholders, this role supports consistent claims documentation and correct authorisation outcomes that meet Group HR and T&C requirements.

Primary Duties

• Develop strong relationships with divisional teams and respond to their requirements appropriately.
• Process claims in accordance with the claims OPM and create claims documents when appropriate.
• Ensure up-to-date records are maintained at all times on company systems.
• Interpret instructions and issues arising, then implement actions according to policies and procedures.
• Ensure compliance with all applicable Group and Company policies, legal requirements, and regulatory standards.
• Ensure correct authorisation is obtained and that HR and T&C records meet Group requirements.

Skills & Qualifications

• A-level Grade A-C or equivalent qualification.
• No prior experience required as training will be provided.
• Basic technical knowledge of FCA regulations as they pertain to insurance intermediaries.
• Understanding of insurance market processes and their impact on the claims process is ideal.
• Competent in Microsoft Word, Excel, and PowerPoint.
• Strong attention to detail, prioritisation, and organisational skills.
• Ability to communicate effectively with internal and external stakeholders.
• Willing to study for professional examinations and undertake required technical training.

Sitting at the intersection of claims investigation and property damage resolution, the Claims Administrator initiates same-day incident notifications, collects and evaluates damage estimates, and authorizes or denies payments in line with company operations standards. Operating across insurer communications, field appraisals, and legal referrals, this role minimizes liability exposure and enables timely settlement of vehicle and property damage claims.

Duties

• Initiate claims notification to the customer on the same day as the incident.
• Document claim file with notes, updates, and decision-making process.
• Collect, review, and evaluate damage estimates and arrange field appraisals when required.
• Verify body shop invoices agree with authorized repair and authorize payment.
• Issue denials on damages not caused by company operations.
• Refer litigation matters to counsel and communicate with insurance and third-party administrators as required.

Requirements

• 3 or more years of claims experience or similar related work experience.
• Experience with auto collision repair procedures.
• Strong organisation and time management skills.
• Excellent written and verbal communication skills.
• Bilingual in English and Spanish or French is a plus.

A key member of the customer service and operations team, the Claims Administrator updates and resolves claims end-to-end within SAP order entry systems while liaising with customers, the sales team, warehouse, and delivery functions. Collaborating across internal departments to manage complaints and answer product enquiries, this role sustains high-quality service delivery and ensures accurate, timely order status communication.

Accountabilities

• Update and complete claims in the SAP order entry system.
• Liaise with customers, sales team, warehouse, re-orders, and deliveries.
• Manage and resolve customer complaints in a professional manner.
• Answer enquiries and provide advice on products.
• Update customers on the status of their orders and file documentation accordingly.
• Support other team members as required.

Experience & Qualifications

• Recent proven experience in a similar claims administrator role.
• Previous experience using SAP systems highly regarded.
• Experience working in a high-volume transactional environment.
• Proficient in SAP and standard office software.
• Self-motivated, able to work under pressure, and maintain a positive can-do attitude.

Efficient resolution of motor and insurance claims depends on the Insurance Claims Administrator, who handles and processes allocated claims within laid-down timescales, liaises with claimants and insurance carriers, and maintains the company insurance system with all relevant documentation. Based within the broader insurance and risk function, this role supports the Insurance and Risk Manager on ad hoc reporting and provides assistance across business units on insurance queries.

Activities

• Handle and process allocated motor and other claims efficiently within laid-down timescales.
• Maintain the company insurance system with all relevant information and documentation.
• Investigate claims and liaise with claimants, insurance carriers, and appropriate departments.
• Undertake general administrative work in relation to all insurance policies and claims as allocated.
• Assist in other areas of the business in relation to insurance queries.
• Assist the Insurance and Risk Manager in preparation of ad hoc reports and presentations.

Technical Qualifications

• Prior experience in claims administration or an insurance-related role preferred.
• Good computer literacy skills including standard office software.
• Confident telephone manner with excellent relationship-building skills.
• High levels of self-motivation and initiative to resolve problems.
• Ability to work in a pressurised environment and manage your own workload independently.

As the Claims Administrator, this role processes weekly domestic and international freight invoices, manages claims filing documentation, and coordinates with trucking companies and operational groups to ensure shipment accuracy and timeliness. The logistics team relies on this work to maintain balanced invoice logs, resolve freight claim disputes, and support export shipment documentation while identifying process improvements across the department.

Job Functions

• Process weekly freight invoices for domestic and international business, including coding, price validation, and invoice disputes.
• Maintain invoice logs and balance incoming checks, and produce invoice and aging reports.
• Ensure all documentation and computer entries are completed accurately and on time for freight claims filing.
• Coordinate with trucking companies to schedule shipments in support of delivery and receipt schedules.
• Coordinate with operational groups and customers to ensure accuracy and timeliness of shipments and material receipts.
• Assist with export shipments and export freight documents, and identify process improvements for the department.

Position Requirements

• High School Diploma or equivalent.
• Minimum 2 years of experience in the traffic logistics field, including work with logistics carriers.
• Experience in freight claims, invoice auditing, and LTL and FTL domestic moves.
• General knowledge of Ocean, Air, LTL, TL, or Rail freight contracts, pricing, and billing practices.
• Proficient in MS Word and Excel.
• Exposure to ERP systems and TMS platforms.
• Strong communication skills.
• Ability to prioritise multiple high-priority tasks, with basic mathematical computation ability.

Claims Administrator delivers an audit review of claims processed by Claims Examiners, verifying benefit payment accuracy against applicable plans and policies and documenting results within required timeframes. The work directly supports team quality improvement by identifying trends and weaknesses, developing training materials, managing the appeal process up to set authority limits, and coordinating system adjustments with Accounting.

Leadership Responsibilities

• Review submitted claim documents to verify that benefits were paid correctly and in accordance with applicable plans and policies.
• Document and track audit results in designated format and within required timeframes.
• Assist manager in identifying trends, weaknesses, and strengths to improve team quality and understanding.
• Develop training materials and conduct training sessions with staff.
• Assist supervisor with the claim appeal process, including research, recommendations, and drafting correspondence.
• Approve appeals up to a set authority limit and refer higher-value cases to management.
• Assist supervisor with system procedures for adjustments, voids, cancellations, or reimbursements, and communicate with Accounting as required.

Knowledge Skills & Abilities

• High school diploma or GED.
• 5 years of progressive experience in claims administration.
• Strong medical knowledge including ICD, CPT, HIPAA, and medical terminology.
• Advanced knowledge of claims principles, practices, and procedures.
• Ability to read and interpret plans of benefits, contracts, claim reports, and procedural manuals.
• Excellent written and verbal communication skills.
• An emphasis on confidentiality, tact, and diplomacy.

The Claims Administrator produces timely investigation and resolution of customer chargebacks, including post-audit trade claims, supply chain penalties, and manufacturer chargebacks, while managing paperless and electronic claim files with active monitoring. Working alongside sales, brand management, operations, and finance, this role advances deduction compliance and enables accurate, well-documented responses that protect revenue and vendor relationships.

Day-to-Day Responsibilities

• Review and assess the validity of customer chargebacks, including post-audit trade claims, supply chain penalties, and manufacturer chargebacks, and formulate a response to each.
• Dispute invalid deductions and follow through until resolution is achieved.
• Coordinate and handle all internal claims investigations and communicate findings to customers and vendors promptly.
• Assist sales reps in gathering current and previous deductions from their customers.
• Establish, maintain, and manage paperless and electronic claim files with active monitoring.
• Act as a key liaison between sales, brand management, operations, and finance to communicate deductions and identify compliance improvements.

Professional Experience

• Post-secondary education in Supply Chain, Business, Operations Management, or a related program.
• Minimum 1 year of experience in claims administration or a similar role.
• Experience working with major retailers.
• Working knowledge of EDI processes preferred.
• Proficient in MS Office including Word, Excel, and Outlook.
• NetSuite experience preferred.
• Strong negotiation, customer service, and interpersonal skills.
• Proven multitasking capability with high accuracy, self-motivation, and the ability to work under pressure to meet deadlines.

Reporting to sales and collections leadership, the Claims Administrator develops and manages complex deduction research, chargeback credit audits, and denial letter preparation while overseeing dispute resolution and appeal processes across customer claims and returns. Partnering with sales, collections, and field teams, this role oversees outstanding balance reduction and enables accurate monthly and field credit reporting that supports supply chain compliance.

Scope of Work

• Monitor outstanding deductions, reconcile balances, and process commission chargebacks against quotes and SPAs.
• Perform complex research on debits for customer claims and returns, and process corresponding credits or denials.
• Approve or deny returns based on policy and manage dispute resolution and appeal processes.
• Audit chargeback credits for duplication or potential drop shipments before approving credit.
• Write denial letters, prepare monthly metric reports, and produce field credit reports.
• Work with sales and collections to minimise outstanding balances, and serve as team OIC and backup supervisor as needed.

Background & Experience

• 4-year college degree, with a business background preferred.
• Customer service experience preferred.
• Knowledge of Export, Import, and Supply Chain Security Policy requirements and ISO Standards.
• Proficient in PowerPoint, Word, Excel, Access, and Outlook.
• Above-average spoken and written communication skills.
• Demonstrated presentation skills to internal contacts during meetings.
• Ability to handle varying workloads.

Reporting to departmental managers, the Claims Administrator refines the end-to-end claims validation process by investigating multiple internal systems and customer-provided documentation to resolve inquiries within contractual SLAs across all lines of business. Partnering with internal and external partners and business units, this role identifies root causes and countermeasures to improve accuracy and claim quality while maintaining a positive client experience.

What You'll Do

• Manage customer interactions by resolving claim inquiries within set timeframes and contractual SLAs.
• Investigate and research relevant documentation to determine claim validity.
• Escalate and process claims within SLA agreements in coordination with internal and external partners.
• Communicate with customers and business units to identify root cause, countermeasures, and accuracy of claim requests.
• Support managers in analyzing, planning, and problem-solving activities, and provide feedback on process improvement opportunities.
• Assist with special projects and provide other administrative support as needed.

Minimum Qualifications

• High School Diploma or GED.
• 2 years of experience in direct customer communication via email, phone, and meetings.
• Financial institution, ATM, Smart Safe, or armored carrier and logistics background preferred.
• Experience using Salesforce or a similar CRM system of record.
• Intermediate Microsoft Office and Excel skills.
• Strong consultative, analytical, problem-solving, and interpersonal communication skills.

Sitting at the intersection of HR operations and benefits compliance, the LOA Claims Administrator evaluates leave documentation, administers payroll corrections, and acts as the primary point of contact for Leave of Absence claims resolution and escalated HR concerns. Operating across HCM technology, case management tools, and benefits systems including COBRA and short and long-term disability, this role enables accurate, compliant leave outcomes and supports manager education across the organization.

Strategic Responsibilities

• Evaluate relevant documentation for appropriate leave outcomes and carry out exceptions and resolutions.
• Act as point of contact for Leave of Absence questions, claims resolution, and escalated concerns.
• Identify employee needs, research escalated HR issues, and provide accurate resolution.
• Perform data entry, complete transactions in appropriate systems, and maintain accurate records.
• Execute payroll processing and corrections using HCM technology and case management tools.
• Participate in educational trainings for managers and act as subject matter expert on benefits, accruals, COBRA, and short- and long-term disability during leave.

Education & Experience

• Associate or Bachelor's degree in HR or a related field required.
• 5 to 7 years of HR experience with emphasis on Leave of Absence, Health and Welfare, Benefits, and Payroll.
• Customer service experience.
• Knowledge of benefits, accruals, COBRA, and short- and long-term disability application during leave.
• Proficient in Microsoft Word, Excel, and Outlook.

A key member of the claims operations team, the Claims Administrator administers end-to-end claims uploaded from members of the client network, handles incoming communication via email and telephone, and produces and distributes weekly reports. Collaborating across client contacts and depot teams, this role ensures clients receive accurate liability guidance, and that contact records and system data are maintained with precision.

Work Activities

• Administer claims uploaded from members of the client network and process claims end-to-end.
• Correspond with clients regarding liability claims and procedures, and assist in training new clients on the claims system.
• Maintain and update contact records, passwords, and usernames for depots.
• Handle incoming claims communication via email and telephone and ensure depots receive guidance on full value cover.
• Produce and distribute weekly reports.

Qualifications & Experience

• No specific degree required; prior claims or administrative experience preferred.
• Strong customer service and administration skills.
• Accurate with excellent attention to detail.
• Good written and verbal communication skills.
• Good IT skills including Excel.

Consistent management of third-party insurance claims depends on the Insurance Claims Administrator, who liaises with contractors to determine liability, collates relevant documentation, and advises insurers and loss adjusters on liability or rejection decisions. Serving as the central point of contact for the insurance claim register, this role enables accurate weekly status reporting and financially sound claim closeout across all third-party submissions.

Ownership Areas

• Manage insurance claims submitted by third parties efficiently and effectively.
• Liaise with third-party contractors to determine parties involved and obtain liability details.
• Collate relevant documents about each claim and update the insurance claim register.
• Advise insurers and loss adjusters of liability or rejection of claims by third-party contractors.
• Produce and distribute weekly reports on the status of insurance claims.

Skills & Qualifications

• Minimum 5 GCSEs including English and Mathematics.
• Minimum 5 years of experience administering insurance claims.
• Demonstrable financial and commercial acumen with a practical, methodical approach.
• Experience operating office management systems, including filing, document control, and distribution.
• Ability to collate information and prepare reports, payment certificates, and financial closeout reports.
• Proficient in Microsoft Word, Excel, and PowerPoint.

As the Claims Administrator, this role processes and codes legal bills, maintains state contractor licenses, and manages corporate filings while providing administrative and paralegal support to the Legal staff across all lines of business. The Legal team relies on this work to ensure timely contract coordination, renewal accuracy, and compliance with state licensing and insurance claims requirements across business units.

Executive Functions

• Maintain standard form contracts and coordinate with each business unit.
• Process and code legal bills accurately and efficiently.
• Maintain compliance of state contractor licenses, including applications and renewals.
• Assist qualified individuals with continuing education or examination paperwork requirements for licenses.
• Prepare and complete state corporate filings and manage company licensing, renewals, and contract updates.
• Provide administrative support for Legal staff and adhere to all company policies and procedures.

Education & Experience

• Bachelor's degree or Paralegal degree required, with equivalent combination of experience and education considered.
• Emphasis in corporate formation and licensing, insurance, and construction preferred.
• Previous administrative experience preferred, with familiarity with the legal system an asset.
• Knowledge of insurance claims process, state contractor licensing, and corporate compliance preferred.
• Proficient in Microsoft Office Suite with ability to learn specific software platforms.
• Strong independent judgment, organisational skills, attention to detail, and ability to handle sensitive and confidential information.

Claims Administrator coordinates the full lifecycle of vehicle and property damage claims, from investigation and liability determination through negotiation, settlement, and record retention, while managing the physical damage surcharge program for financed trailer units. The work directly supports month-end reporting accuracy and subrogation recovery by maintaining record databases, communicating with body shops and claimants, and coordinating with insurance adjusters to achieve adequate settlement.

Key Deliverables

• Investigate vehicle and property damage claims, including reviewing estimates, photographs, and accident reports.
• Communicate with claimants and body shops, and negotiate settlements on subrogation files.
• Ensure proper physical damage insurance coverage for financed trailer units and administer the physical damage surcharge program.
• Maintain record database and physical files and prepare month-end reports.
• Coordinate with insurance adjusters and take appropriate steps to pursue adequate settlement.

Qualifications & Experience

• Associate degree required; Bachelor's degree preferred.
• 5 to 7 years of job-related claims experience.
• General knowledge of insurance claims process and related state regulations.
• Strong knowledge of database, spreadsheet, and word processing software including Microsoft Office.
• Experience with order processing software such as CMS.
• Excellent problem-solving, analytical, organisational, and communication skills.
• Ability to manage multiple priorities independently.

The Claims Administrator creates accurate benefit payment calculations and processes medical claims, invoices, and group benefit registrations for employees and members across health and welfare benefit plans. Working alongside insurance companies and internal teams, this role delivers compliant, timely claims processing that ensures employees receive correct plan benefits and that all administrative and reception functions are covered as needed.

Role Responsibilities

• Communicate with employees and members by phone and email regarding health and welfare benefit plans.
• Calculate benefit payments accurately and apply the terms of the benefits plan.
• Process medical claims, verify invoices, and prepare and process payments.
• Register new employees for group benefits and perform data entry of medical claims.
• Liaise with insurance companies in relation to employee benefits.
• Perform filing and other administrative duties, including reception coverage as required.

Requirements

• 2 or more years of experience processing medical or health claims.
• Knowledge of health and welfare benefit plans and their terms and conditions.
• Proficient in Microsoft Word, Excel, and Outlook, as well as AS400 systems.
• Strong verbal and written communication skills with attention to detail.
• Comfortable working in a fast-paced environment and able to follow office procedures.

Embedded within the Structural Defects Department, the Claims Administrator administers the full claim lifecycle, from taking initial FNOL calls and issuing claim forms through scheduling loss adjusters, processing documentation, and uploading payment requisitions, in support of high-calibre client service. Working closely with the Account Manager and Structural Defects Director, this role enables accurate diary management, audit preparation, and litigation support that meets minimum competency requirements for clients, colleagues, and third parties.

Delivery Expectations

• Maintain electronic and hard copy filing systems and administer incoming correspondence.
• Schedule deployment of loss adjusters and arrange their appointments.
• Take initial and scripted FNOL calls and issue claim forms to policyholders following first notification of loss.
• Enter new claims and process initial claim documentation, including obtaining historical information and key policy documents.
• Administer the claim lifecycle including diary reminders, payment requests, and uploading of payment requisitions and invoices.
• Assist the Account Manager and Structural Defects Director in preparation for meetings, audits, and litigation.

Professional Experience

• Minimum competency requirements accredited or willingness to progress to accreditation.
• Employment background in financial services desirable.
• Experience working within a facilities function or department desirable.
• High proficiency in Word, Excel, and PowerPoint with sound numeric skills.
• High attention to detail.
• Strong interpersonal and communication skills; French language proficiency highly desired.

Reporting to branch and finance management, the Claims Administrator executes end-to-end vehicle administration from collection through auction readiness, capturing information into internal systems and eliminating additional costs by following correct administration processes. Partnering with suppliers, branches, clients, and other departments, this role ensures the Finance Department can make payments correctly and within agreed timeframes while maintaining full process transparency.

Areas of Ownership

• Act as liaison between supplier, company, and customer from vehicle collection through to auction readiness.
• Work in accordance with Administration Standard Operating Procedures at all times.
• Capture required information and notes into the internal system electronically to ensure process transparency.
• Eliminate additional costs by following correct administration processes at all times.
• Ensure the Finance Department can make payments correctly and within agreed timeframes.
• Assist suppliers, branches, clients, and other departments with supplier account queries daily.

Minimum Qualifications

• Matric Certificate.
• 2 to 3 years of experience in an office administration position.
• Computer literate in MS Word, Excel, PowerPoint, and Outlook.
• Process-driven with good communication skills.
• Valid driver's licence.

Sitting at the intersection of legal operations and insurance risk, the Claims Administrator elevates claims management system accuracy by inputting and analyzing new matters, updating reserves and payment records, and producing statistical trend reports for insurers and internal stakeholders. Operating across the PII team, Accounts Payable, and case managers, this role enables compliant Legal Hold administration, timely settlement payments, and well-coordinated Annual Declaration support.

Strategic Responsibilities

• Maintain and develop the claims management system, including input and analysis of new matters, updating records for reserves and payments, and providing reports on data trends.
• Monitor the Practice Protection inbox to ensure all new matters are notified to the relevant team.
• Work with the PII team on preparation and turnaround of quarterly reports to insurers.
• Administer Legal Hold processes and maintain KPI Watch lists and document retention search terms.
• Ensure all draft invoices are saved, approved, and filed correctly, and instruct Accounts Payable to make settlement payments.
• Assist with the Annual Declaration process and provide support to case managers on claim handling.

Required Qualifications

• Prior experience in claims administration or a legal or insurance environment preferred.
• Strong analytical skills with ability to produce reports on statistical trends and address specific information requests.
• Advanced proficiency in Excel, Word, and PowerPoint.
• High attention to detail with strong written and oral communication skills, including ability to work with international contacts.
• Tact and diplomacy in handling sensitive and confidential information.
• Strong organisational skills with ability to prioritise effectively and work independently.

A key member of the benefits administration team, the Claims Administrator coordinates daily claims and substantiation processing for FSA and HRA programs, implements operational controls for client and participant record security, and reports progress and performance to the Department Manager. Collaborating across internal departments to resolve client satisfaction issues and handle special projects, this role ensures continuous process improvement and compliant administration of applicable regulatory requirements.

Performance Expectations

• Process and upload daily payments accurately and ensure timely mailing.
• Implement and maintain operational controls to ensure security and confidentiality of client and participant records.
• Process claims and substantiation daily and ensure client and participant questions are resolved.
• Promote continuous evaluation and improvement of administrative processes, including HSA procedures.
• Maintain excellent customer service on all calls and report progress and performance to the Department Manager.
• Work cooperatively with other departments to coordinate resources and resolve issues affecting client satisfaction, and handle special projects as assigned.

Experience & Qualifications

• Bachelor's degree required.
• Specific FSA and HRA administration experience required.
• Advanced knowledge of FSA and HRA laws and applicable regulatory requirements.
• Strong time management, multitasking, and project planning and management skills.
• Relationship-building ability with strong communication skills.

Consistent, customer-centric claims outcomes depend on the Claims Administrator, who processes pending claims in accordance with company policy, policy terms and conditions, and DOI regulations while managing customer queries across email, telephone, and social media channels. Based within a growing claims team, this role enables fraud identification, regulatory compliance, and continuous product and process improvement through peer collaboration, trend analysis, and escalation of complex cases to the Team Leader.

Operational Focus

• Process pending claims in accordance with company policy, policy terms and conditions, and DOI regulations.
• Manage customer queries and requests through email, telephone, and social media channels.
• Handle complaints constructively in line with company and DOI guidelines and escalate tricky cases to the Team Leader as needed.
• Investigate claims to ensure all relevant documents and information have been evaluated before completion.
• Identify possible fraudulent or questionable claims and alert the Team Leader to potential risks.
• Participate in peer development and training, identify trends and risks, and champion product and process improvements.

Background & Experience

• Undergraduate degree in Animal Science or a related field preferred.
• Property and casualty producer and adjuster licence required or to be obtained within 30 days.
• Veterinary background such as technician, receptionist, or hospital manager experience preferred.
• Insurance and claims experience, ideally in pet or health product lines, is a plus.
• Experience managing complex documentation and regulated record-keeping with high accuracy and attention to detail.
• High emotional intelligence and active listening skills.
• Strong time management and pragmatic data-driven decision-making ability.

As the Claims Administrator, this role coordinates daily administrative support to the insurance claims team, including opening and distributing mail, updating records and databases, and overseeing submission of death claims to carriers and monitoring carrier responses. The claims and client services teams rely on this work to maintain accurate company and client documentation, compile policy and license records, and ensure timely follow-up on all required data across departmental projects.

Core Responsibilities

• Provide daily administrative support to the insurance claims team, including opening, sorting, and distributing mail and preparing courier packages.
• Research and collect information from various sources and follow up to ensure all required data is provided.
• Update records, files, and computer databases and assist departmental management with projects and presentation preparation.
• Compile documentation and maintain records related to company and client information, policies, licenses, and reports.
• Enter death certificate information into a central database, oversee submission of death claims to carriers, and monitor carrier responses.
• Assist Carrier Analysts, Client Services, and other departments as needed, and collaborate openly with colleagues.

Knowledge Skills & Abilities

• 2 to 5 years of related experience or equivalent combination of education and experience.
• Prior experience in insurance claims administration or a related support role preferred.
• Strong MS Office skills including Word, PowerPoint, and Excel.
• Diplomatic, resourceful, and client-oriented with sound judgment and integrity.
• Creative problem-solving ability.
• Strong attention to detail, organisation, planning, and time management skills.

Claims Administrator guides work-related injury claims from inception to closure, coordinates with injured workers, claims adjusters, and broker contacts, and leads quarterly safety committee meetings and loss control training initiatives across multiple facilities. The work directly supports OSHA and workers' compensation regulatory compliance by tracking accident causes, providing monthly statistical loss reporting, and maintaining mandatory postings across all locations.

Accountabilities

• Manage work-related injury claims from inception to closure and monitor time-lost and restricted-duty claims regularly.
• Communicate with injured workers, claims adjusters, and broker contacts in a timely and empathetic manner.
• Ensure managers are aware of injured workers' restrictions and are complying with all worksite instructions.
• Track and document accidents and incidents to identify causes and recommend preventive changes, and provide monthly statistical reporting on loss and cause analysis.
• Perform periodic facility inspections and audits, implement loss control and safety training initiatives, and lead quarterly safety committee meetings.
• Maintain compliance with federal, state, and local workers' compensation and safety laws, and distribute mandatory postings to new locations.

Required Qualifications

• Bachelor's degree preferred but not required.
• 3 to 5 years of experience in safety, loss prevention, and claims management.
• Working knowledge of OSHA laws, workers' compensation regulations across multiple states, and DOT regulations.
• Working knowledge of property and casualty claims processes.
• Expert proficiency in Microsoft Outlook, Word, Excel, and PowerPoint.
• Strong self-management, conceptual thinking, attention to detail, and written and verbal communication skills.
• Ability to lead cross-functional teamwork.

The Claims Administrator crafts comprehensive administration of workers' compensation and property/casualty claims by monitoring and settling claims, generating reports, and maintaining relationships with adjusters, insurers, and outside legal counsel. Working alongside employees, managers, medical staff, and regulators, this role drives improvements to claims outcomes and organizational risk management practices through data analysis, policy guidance, and ongoing professional development.

Key Responsibilities

• Monitor and administer claims, generate reports, and communicate with employees, managers, insurance carriers, medical staff, and lawyers.
• Provide guidance on workers' compensation claims policies and procedures and oversee adherence to written administrative procedures.
• Deny, settle, or authorise payments on complex property and casualty claims based on coverage, appraisal, and verifiable damage.
• Manage litigated and moderately complex claims with significant settlement authority, and maintain relationships with adjusters, insurers, and outside legal counsel.
• Analyse and review risk management data, collate findings, and drive improvements to workers' compensation claims outcomes.
• Keep current with trends and developments in the risk management field through publications, conferences, and professional contacts.

Qualifications & Experience

• Four-year college degree preferred, with concentration in Workers' Compensation, Risk Management, or a related field.
• Relevant professional certifications such as AIC or ARM preferred.
• 3 years of experience in workers' compensation, auto liability, or general liability claims management.
• General understanding of various state workers' compensation laws, OSHA, and DOT regulations.
• Experience with lean, six sigma, or similar process-improvement methodologies preferred.
• Proficient in Word, Excel, PowerPoint, and Outlook.
• Ability to learn claims management software platforms.
• Strong analytical ability, business judgment, and communication skills.
• Must maintain strict confidentiality.