CLAIMS ASSOCIATE JOB DESCRIPTION

Auto insurance volume creates thousands of vehicle damage incidents every week, and the speed and accuracy with which each one is resolved shapes both customer loyalty and carrier loss ratios. Claims Associates in this segment own the investigation and settlement cycle for individual vehicle damage and total-loss files, operating within property damage units that must balance fair valuation against subrogation recovery. The role demands working knowledge of coverage verification, state compliance letters, and ISO carrier identification. It matters because unresolved files age into litigation.

The mandate of the Claims Associate is to investigate, evaluate, and resolve vehicle damage and auto liability claims to a fair outcome, ensuring coverage accuracy and prompt payment within regulatory timelines. Working within a property damage or express claims unit, this individual manages an assigned file inventory with regular oversight from a claims supervisor and cross-functional contact with third-party administrators, body shops, and rental vendors.

Career Impact: Hands-on adjudication of auto liability and property damage files builds the investigation and negotiation credentials that underpin advancement to Claims Adjuster or Claims Examiner roles in the P&C market.

Business Impact: Timely, accurate settlement decisions on vehicle damage claims directly reduce loss reserve aging and protect the carrier's combined ratio on personal and commercial auto lines.

Growth Opportunity: Exposure to subrogation identification, ISO carrier lookup, and state-specific compliance requirements positions associates to pursue a state adjuster license and take on higher-severity caseloads.

• Investigate vehicle damage and auto liability claims by reviewing coverage, policy conditions, and relevant state statutes to determine the extent of obligation.
• Evaluate damage reports, police reports, and loss documentation to establish fair market value for vehicle repairs or total-loss settlements.
• Coordinate vehicle inspection appointments, repair shop assignments, and rental authorizations for claimants with active files.
• Negotiate settlements with claimants, attorneys, and third-party carriers on non-litigated files within assigned authority limits.
• Identify subrogation potential and refer qualifying files to the appropriate supervisor or recovery unit.
• Review and input payment approvals for estimates while ensuring required compliance correspondence is issued within statutory deadlines.
• Collaborate with third-party administrators and field appraisal vendors to resolve open files and escalate cases exceeding express handling criteria to the property damage unit.
• Document all claim activity, contact notes, and reserve changes accurately in the claims management system.

• Bachelor's degree in any field or equivalent work experience.
• 1 or more years of auto claims handling, customer service, or insurance-related experience, with demonstrated ability to manage a file inventory.
• Working knowledge of coverage verification, policy interpretation, and state regulatory requirements applicable to auto claims.
• Ability to conduct structured investigations, including reviewing damage estimates, police reports, and recorded statements.
• Strong written and verbal communication skills for interactions with claimants, body shops, attorneys, and internal teams.
• Demonstrated analytical and decision-making ability to evaluate claim facts and reach fair, timely resolutions.
• Proficiency with standard office productivity software and comfort navigating multiple claims and document management systems simultaneously.
• Willingness to obtain a state claims adjuster license where required within 90 days of hire.

• Prior experience with a major auto insurance carrier, car rental company, or peer-to-peer vehicle sharing platform handling vehicle damage claims.
• Familiarity with ISO carrier identification tools or subrogation recovery workflows in a personal or commercial auto environment.
• Experience processing total-loss valuations for commercial or recreational vehicles using proprietary valuation databases.
• State claims adjuster license already obtained in one or more jurisdictions.

• File closure rate per week, reflecting throughput against assigned auto damage inventory.
• Average days to first contact on new losses, measuring responsiveness against regulatory and SLA requirements.
• Reserve accuracy ratio, tracking the variance between initial reserve and ultimate settlement amount per closed file.
• Subrogation referral rate, measuring the share of eligible files correctly identified and escalated for recovery.
• Compliance letter issuance rate within statutory deadlines, ensuring zero tolerance for late required correspondence.
• Typical tools: Claims management platforms (commonly ClaimsPro or similar); carrier lookup and subrogation tools (commonly ISO ClaimSearch).

• Base Salary Range: $40,000 to $55,000 per year
• Bonus: Annual performance bonus, typically 5% to 8% of base salary
• Equity: Not typical at this level in the insurance sector
• Health Benefits: Medical, dental, and vision coverage; employer contributes to premiums
• PTO: 15 to 20 days per year plus federal holidays
• Common Perks: Licensing exam reimbursement, remote or hybrid scheduling after training, employee assistance program

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

Successful completion of a background check, including driving record review, is a condition of employment for this role. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, genetic information, veteran status, or any other characteristic protected under applicable federal, state, or local law. Applicants requiring a reasonable accommodation to participate in the hiring process should notify the recruiting team. Candidates must be authorized to work in the United States.

The Claims Associate owns the adjudication of medical claims against EOC, Benefit Schedules, and Provider Contracts, releasing files by regulatory and contractual deadlines in a high-production payer environment. Reporting to departmental management, this individual ensures accuracy, confidentiality, and compliance with federal and SHS guidelines across all claim processing functions.

Key Responsibilities

• Adjudicate claims to quality and production standards applicable to this position.
• Monitor work inventory and submit non-I Max sheets completed accurately by first day of each month.
• Analyze medical claims to ensure accurate claims adjudication.
• Process claims in accordance with EOC, Benefit Schedules and Provider Contracts.
• Release claims by deadline to meet company, state regulations, contractual agreements and group performance standards.
• Identify and report problems to management.
• Resolve priority projects.
• Perform all job functions with a high degree of discretion and confidentiality in compliance with federal, SHS, and departmental confidentiality guidelines.

Required Qualifications

• High school diploma, GED, or equivalent years of work experience.
• CPT coding certificate or equivalent medical billing credential preferred.
• 1 or more years of experience with medical claims processing in a payer setting.
• Experience in medical terminology, ICD-10, CPT coding, HCPCS, ASA, insurance certificates, benefit schedules, and provider contracts.
• 6 or more months of clerical experience in a medical office environment or medical billing.
• Proficiency with Windows and PC applications, including the ability to navigate multiple programs and learn new systems.
• Ability to maintain confidentiality and keep all company-sensitive documents secure.

Embedded within a peer-to-peer vehicle sharing platform's claims team, the Claims Associate delivers exceptional customer service and end-to-end auto claims processing for owners and travelers. Working closely with a third-party administrator and internal operations, this individual drives continuous improvement in claims handling processes and cost management outcomes.

Core Functions

• Provide exceptional customer service for owners and travelers.
• Investigate and process auto claims filed by owners and travelers.
• Assist members in the self-resolution process when possible.
• Coordinate claims processing with the third-party administrator.
• Collect any amounts due from renters.
• Maintain accurate documentation.
• Contribute to continuous improvement in claims handling processes and cost management.

Qualifications & Experience

• Bachelor's degree or equivalent preferred.
• State claims license desirable.
• 1 or more years of experience in auto claims handling, preferably with a major auto insurance carrier or car rental company.
• Strong proficiency with CRM systems, claims management systems, Google Docs, MS Office, and mobile systems.
• Strong conflict resolution, de-escalation, and interpersonal skills.
• Excellent follow-through, attention to detail, and ability to work with minimal supervision.
• High responsiveness, availability, and commitment to customer service excellence.

Reporting to a claims supervisor, the Claims Associate investigates, negotiates, and resolves severity claims following established company protocols and state statutes. Partnering with internal teams and external parties, this individual ensures timely, fact-based communication across all claim files and delivers consistent service quality to claimants and customers.

Primary Duties

• Review, process, and conclude severity claims following company protocols and trained methodology.
• Ensure quality and timely service is provided to all customers, whether interacting directly or indirectly.
• Verify coverage and policy conditions, including relevant state statutes, and review issues with supervisor as needed.
• Investigate and evaluate all data, statements, and pertinent information.
• Negotiate and resolve non-litigated claims with oversight and coaching from supervisor.
• Write clearly, succinctly, and factually in claims files and all other communications.
• Manage time and diary entries effectively, prioritizing work in a fast-paced environment.

Skills & Qualifications

• Bachelor's degree or equivalent related experience.
• Knowledge of insurance theory and practices.
• Demonstrated skills in investigation, evaluation, and negotiation.
• Proficiency with MS Office Suite.
• Strong customer service skills.
• Strong critical thinking and decision-making skills to gather, assess, analyze, and interpret key issues.
• Ability to learn technical materials and apply lessons learned to achieve best outcomes for claimants and customers.

Sitting at the intersection of customer advocacy and clinical claims management, the Claims Associate manages end-to-end claim closure while collaborating with Consultants and Quality Assessors to improve policyholder recovery outcomes. Operating across individual and team SLAs, this individual maintains risk and compliance measures while ensuring every customer interaction reflects empathy and ethical standards.

Duties

• Manage claims from initial assessment through to claim closure.
• Work to individual and team SLAs to ensure customers receive support during their time of need.
• Collaborate with Consultants and Quality Assessors to improve outcomes for customers.
• Conduct every interaction with empathy and respect.
• Contribute to system and process improvements and maintain risk and compliance measures.

Experience & Qualifications

• Allied Health qualification, occupational rehabilitation experience, or relevant tertiary qualifications.
• 1 or 2 years of experience in a customer service environment.
• Experience in the Allied Health and Rehabilitation sectors desirable.
• Ability to establish rapport and build meaningful relationships.
• Experience working in a highly collaborative environment.
• Resilience and strong outcomes focus.

A key member of the claims training unit, the Claims Associate builds foundational skills in loss registration, coverage verification, and jurisdictional handling while developing toward a full claims representative role. Collaborating across agents, insureds, and internal claim staff, this individual delivers administrative support and entry-level claims functions that keep caseload intake accurate and current.

Functions

• Assist with new losses and verify accuracy of information via coverage.
• Register new loss information, file updates, and loss payments on the system.
• Deal with agents, insureds, clients, and other customers via verification and complete loss registration forms.
• Handle jurisdictional notices, payment of benefits, scheduling medical appointments, and filing of necessary forms.
• Handle entry-level rep duties on minor claims and assist with initial claim investigations.
• Perform other administrative duties for the team as assigned.

Education & Experience

• College degree required, no prior experience necessary.
• Strong customer orientation with excellent written and oral communication skills.
• Strong analytical, organizational, and PC skills with typing ability of 35 to 45 wpm.
• Ability to work well within a team environment, give and solicit feedback, and identify growth opportunities.
• Committed to high standards of behavior and performance, with the ability to adapt approach to particular situations.

Fair and timely resolution of vehicle damage claims depends on the Claims Associate, who investigates, evaluates, and processes each file to a fair outcome while coordinating repairs and cost recovery through third-party administrators and insurance carriers. Based within a cross-functional claims team, this individual guides car owners and renters through the full process via phone and email support.

Accountabilities

• Investigate and evaluate claims to reach a fair outcome.
• Guide owners and renters through the claims process by providing a positive experience.
• Communicate with customers via phone and email.
• Enter and process claims accurately and efficiently using internal tools and software.
• Manage an inventory of vehicle damage claims.
• Facilitate vehicle repairs via third-party claims administrators and vendor partners and recover costs from responsible parties and insurance carriers.
• Work cross-functionally with other teams to ensure damage claims are resolved quickly.

Background & Experience

• Bachelor's degree or equivalent experience.
• 1 to 3 years of customer service experience, especially with phone and email support.
• Proficiency with Google Sheets or Microsoft Excel.
• Strong time management, organizational skills, and ability to meet deadlines.
• Ability to thrive in a fast-paced environment with weekend availability.

As the Claims Associate, this role advances analytical support for Claims Operations through data research, process analysis, audit coordination, and regulatory change management. The Claims Operations team relies on this work to identify process improvement opportunities, document business requirements, and produce written recommendations that inform system development and policy decisions.

Role Responsibilities

• Research and analyze data and business operations to identify trends, issues, or areas for process improvement.
• Develop or assist in developing plans and proposals to address identified issues.
• Participate in the development and management of project plans from planning through testing, implementation, and maintenance.
• Prepare written reports and verbal presentations summarizing project objectives, analysis, conclusions, and recommendations.
• Analyze current processes and identify existing or potential problems to discover new process improvement opportunities.
• Assist the Claims Audit team in managing audits and exams, including coordination, supporting deliverables, and drafting accurate and concise responses.

Qualifications & Experience

• Bachelor's degree with 2 or more years of experience.
• Claims and/or Grievance and Appeals experience.
• Strong knowledge of provider credentialing, contracting, processing concepts, policies, guidelines, and systems.
• Strong analytical, problem-solving, and structured analysis skills.
• Proficiency in Microsoft Office including Word, Excel, and Outlook.
• Strong organizational and time management skills with the ability to manage multiple priorities.
• Ability to adapt to change, maintain confidentiality, and remain customer-focused.

Claims Associate delivers timely, accurate benefit payment decisions on complex long-term disability claims by independently managing an assigned caseload through investigation, interviews, and coordination with claimants, policyholders, brokers, and legal counsel. Success in the position means maintaining departmental accuracy and performance standards while conducting proactive, empathetic communications with all internal and external customers.

Day-to-Day Responsibilities

• Provide quality claim decisions and timely, accurate benefit payments in accordance with policy provisions, regulations, and claim procedures for complex claims.
• Investigate complex claims independently using clinical and vocational consults, peer reviews, medical examinations, motor vehicle reports, and surveillance.
• Conduct proactive, empathetic communications with internal and external customers.
• Identify and refer matters to legal counsel, accounting, or escalate claim issues with minimal leadership oversight.
• Actively contribute to achieving and maintaining departmental deadlines, accuracy, and performance standards.
• Conduct effective interviews with claimants, policyholders, medical providers, and attorneys to obtain all relevant claim facts.

Knowledge, Skills & Abilities

• High school diploma or GED required; Bachelor's degree preferred in Business Management, Operations Management, Statistics, or Insurance.
• LOMA or ICA certification ideal.
• 2 or more years of prior experience within a claims operation.
• Knowledge of medical terminology preferred.
• Strong mathematical ability and decision-making skills to analyze complex information.
• Customer service experience.
• Proficiency with Microsoft applications.

The Claims Associate produces measurable improvements in fraud identification, prevention, and claims recovery by supervising a specialist team within a financial services fraud and claims program. Reporting to fraud and claims management, this individual oversees resource allocation, performance standards, training development, and compliance with internal policies and government regulations.

Leadership Responsibilities

• Supervise a team of specialists within a fraud and claims program for proactive fraud identification, prevention, and detection.
• Ensure recovery, execution, and handling of claims meet program standards.
• Identify opportunities for process improvement and risk control development to maximize efficiency and customer service.
• Make supervisory decisions and resolve work distribution issues under the direction of fraud and claims management.
• Establish performance standards, evaluate performance, develop training materials, and ensure compliance with internal policies and government regulations.
• Collaborate with customers, vendors, and other functional areas to resolve escalated issues.
• Manage allocation of people and financial resources for Fraud and Claims Operations and mentor direct reports.

Professional Experience

• 2 or more years of experience in Financial Services, Fraud, or Investigation.
• 1 or more years of leadership experience coaching teams to exceed departmental objectives.
• Fraud and claims research experience, including experience with Zelle claims.
• Experience resolving escalated and complex customer issues.
• Basic Microsoft Office skills.
• Strong organizational, multitasking, problem-solving, and interpersonal communication skills.
• Ability to motivate staff, provide performance feedback, maintain confidentiality, and recognize service opportunities.

Embedded within a remote valuation team supporting top insurers nationwide, the Claims Associate produces fair market value research for commercial and recreational product lines involved in total-loss settlements. Working closely with dealerships and claim adjusters, this individual maintains accurate pricing data and productive relationships while adhering to attendance, production, and quality standards.

What You'll Do

• Establish fair market value for commercial and recreational product lines to assist insurers in claim settlement.
• Update information and determine the availability and price of new or used commercial and recreational equipment.
• Conduct outbound calls to dealerships and adjusters as needed for research purposes.
• Maintain relationships with dealers and claim adjusters.
• Provide supplemental research as requested and adhere to attendance, production, quality, and other metric standards.

Minimum Qualifications

• High school diploma required.
• Prior commercial and/or recreational claims experience required.
• Strong keyboarding, PC, and technical aptitude skills.
• Excellent verbal and written communication skills with strong attention to detail.
• Ability to multi-task, work independently, and maintain weekday schedule flexibility.
• Self-motivated with a positive attitude and commitment to outstanding customer service.

Reporting to a claim manager, the Claims Associate investigates and settles low-severity excess casualty claims while acting as liaison between brokers, insureds, and underwriting to improve the claim handling process. Partnering with legal vendors through Legal eXchange and attending mediations as required, this individual monitors long-tail casualty files and processes indemnity and loss expense payments within assigned authority limits.

Scope of Work

• Evaluate, reserve, and manage disposition of assigned low-severity claims under supervision during the training process.
• Make initial contact with insureds and brokers on assigned claims and monitor ongoing claim activity.
• Set up matters in Legal eXchange under supervisor direction, including adding firms and approving bills.
• Process indemnity and loss expense payments on assigned losses within authority or as approved by manager.
• Attend mediations or trials as required.

Position Requirements

• College degree preferred, or 2 to 3 years of property and casualty claims experience instead of a degree.
• Ability to obtain and maintain state claims adjuster licensure, including non-resident licenses where required.
• Knowledge of claim systems, claim processes, and casualty claim topics.
• Intermediate to advanced proficiency in MS Word, Excel, PowerPoint, and SharePoint.
• Strong written and interpersonal communication skills.
• Ability to prioritize and learn quickly.
• Demonstrated ability to work in a hybrid environment as a team player.

Sitting at the intersection of medical management and jurisdictional compliance, the Claims Associate oversees medical-only, limited lost time, and permanent total workers' compensation claims from First Notice of Loss through benefit administration and closure. Operating across network physicians, supervisors, and policyholders, this individual authorizes treatment, identifies subrogation referrals, and ensures timely form filing in all mandated states.

Areas of Ownership

• Proactively manage medical-only, limited lost time, and permanent total claims to minimize losses and provide superior customer service.
• Contact accounts on First Notices of Loss to obtain missing information pertinent to file set-up.
• Process payments, answer calls, authorize treatment, and complete required contacts within 24 hours of assignment.
• Determine whether treatment is appropriate and causally related to the compensable injury and redirect to network physicians as needed.
• Refer subrogation potential and permanency claims to supervisor and ensure compliance with jurisdictional requirements including timely form filing.
• Administer benefits on Permanent Total or Death cases, monitoring for changes in life or work status and marked increases in costs.

Technical Qualifications

• High school diploma or equivalent.
• State claims adjuster license required or ability to obtain within 90 days of hire.
• 1 or more years of Workers' Compensation claims handling experience.
• Familiarity with medical terminology.
• Proficiency in MS Excel and MS Word.
• Ability to work independently, handle multiple tasks simultaneously, and make difficult decisions with strong organizational skills.
• Excellent verbal and written communication skills.

A key member of the Express claims channel team, the Claims Associate oversees voice and email contact management, vehicle dispatch, and compliance letter issuance for auto insurance customers while routing files that exceed channel criteria to the Property Damage Unit. Collaborating across appraisal and subrogation units, this individual uses ISO and LexisNexis to identify carriers and ensures accurate payment input and police report documentation.

Job Functions

• Manage voice and email contacts from customers with active claims and review files to confirm Express channel handling criteria are met.
• Assist callers with vehicle inspection appointments, rental authorizations, and dispatch or rescheduling of vehicles to field, shop, or VET units.
• Refer appraisal complaints to the appropriate unit and use ISO and LexisNexis to identify carriers for subrogation.
• Review and document police reports, identify potential injuries, review estimates, and input payment.
• Ensure proper compliance letters are sent and assist with incoming and outgoing mail.
• Provide leadership to others through example and knowledge sharing.

Required Qualifications

• High school diploma required.
• 1 to 3 years of customer service or insurance background preferred.
• Working knowledge of Microsoft Word, Excel, Outlook, and Internet.
• Working knowledge of ClaimsPro and ImageRight preferred.
• Strong analytical, problem-resolution, and interpersonal skills.
• Ability to multitask, work under pressure, and perform with minimal supervision.

Accurate, on-site investigation of property losses depends on the Claims Associate, who conducts thorough field examinations, consults experts, and negotiates equitable settlements with attorneys and other parties across branch-assigned files. Serving as the primary customer contact throughout the claims process, this individual balances field investigation with in-office file reporting to maintain caseload documentation and deliver service at every touchpoint.

Delivery Expectations

• Conduct thorough claim investigations including assessing loss sites, performing research, and consulting experts.
• Balance investigations with file reporting in the branch office.
• Analyze information and make decisions on claim files.
• Educate customers, vendors, and other involved parties throughout the claims process.
• Negotiate with attorneys and other parties to ensure fair and equitable claim settlements.
• Acquire and apply knowledge of legal concepts, medical terminology, and home construction while delivering extraordinary customer service at every touchpoint.

Qualifications & Experience

• Bachelor's degree, any major.
• Demonstrated customer service and investigation experience.
• Strong written, verbal, and interpersonal communication skills.
• Physical ability to lift up to 15 pounds, work in varied environments, including confined spaces, and inspect all physical aspects of a property.
• Ability to work under all environmental conditions, including low and high temperatures, outdoor elements, and hazardous conditions.
• Valid driver's license with ability to drive up to 4 hours per day.

As the Claims Associate, this role advances operational compliance and claim assignment coordination for a remote crop claims office, acting as liaison between the Call Center and the claims department. The crop claims team relies on this work to ensure all activities align with Operations Best Practices, reporting requirements are met through appropriate monitoring controls, and escalated issues are resolved for internal partners.

Work Activities

• Apply knowledge of complex operational best practices and procedures to daily activities.
• Manage and support key support functions for the office as outlined in Operations Best Practices.
• Ensure compliance with operational reporting requirements through appropriate monitoring controls.
• Provide expertise on the claim assignment process and act as liaison with the Call Center on behalf of the department.
• Respond to customer inquiries quickly, accurately, and professionally and offer escalated problem resolution for internal partners.
• Identify and resolve problems using procedural documentation and implement process improvement ideas to improve efficiency.

Education & Experience

• High school diploma or equivalent with 3 or more years of experience in Claims or Operations, or Zurich Certified Insurance Apprentice with an Associate Degree and 1 or more years of relevant experience.
• Excellent Microsoft Office skills.
• Good written, verbal, and organizational skills.
• Strong problem-solving skills.
• Ability to guide team members and business partners.

Claims Associate coordinates benefit recovery across multiple payers on medical, Workers' Compensation, and motor vehicle claims, processing submissions to the appropriate carrier within 24 hours of receiving adequate billing information. Success in the position means ensuring all available benefits are recovered at maximum reimbursement levels through appeals, account summaries, and timely correspondence with patients, attorneys, and third-party carriers.

Performance Expectations

• Identify viable payers and obtain all necessary documentation to properly process claims for payment, including IBs, UBs, Medical Records, POs, and EOBs as needed.
• Coordinate benefits with all available payers to maximize client recovery while minimizing patient personal responsibility.
• Review and process claims for payment to the appropriate insurance carrier within 24 hours of receiving adequate billing information.
• Correspond with patients, policyholders, insurers, police, witnesses, and attorneys to obtain information supporting the claim.
• Review litigated claim status and confer with attorneys and third-party carriers regarding case disposition.
• Appeal to insurers when appropriate to guarantee all available benefits are recovered, and claims are reimbursed at maximum levels.
• Respond professionally to customer inquiries, prepare account summaries, offers of compromise, and pro-ration of funds.

Minimum Qualifications

• High school diploma or GED required.
• 2 years of directly related industry experience, or relevant education as substitute.
• Experience reading and understanding UB04 and HCFA forms.
• Experience in Workers' Compensation and Motor Vehicle Claims processing.
• Good interpersonal and negotiation skills.
• Ability to work in a team environment.

The Claims Associate creates and maintains an effective Group Customer Support Services Unit by planning, supervising, and coordinating claims employees across staffing, scheduling, job assignment, and compliance with state regulations on group health products. Reporting to division leadership, this individual ensures cross-training, production quality, and accurate daily, weekly, and monthly reporting to support projections and staffing decisions.

Strategic Responsibilities

• Plan, supervise, and coordinate the work of Claims employees including staffing, scheduling, and job assignment to accomplish assigned tasks and contribute to division effectiveness.
• Conduct progress development reviews, counsel employees, evaluate potential, and provide recommendations to management regarding staffing, promotions, and related actions.
• Review production and quality of work and ensure cross-training to maximize unit productivity.
• Maintain daily, weekly, and monthly reporting for future reference and projections.
• Ensure compliance with state regulations and interpret and apply laws as applicable.

Experience & Qualifications

• Bachelor's degree in business or a related field.
• 3 or more years of experience, preferably in the life and health insurance industry.
• Demonstrated competency in all supervisor functions with the ability to lead, coach, and develop team members.
• Proficiency in Microsoft Office with strong computer skills.
• Previous experience with Avaya, Verint, or v11 applications a plus.
• Excellent customer service and organizational skills.

Embedded within a vehicle-sharing platform's Operations and Member Services teams, the Claims Associate executes vehicle damage analysis, risk trend reporting, and workflow improvement initiatives to reduce overall claims activity and improve member outcomes. Working closely with the data team, claims administrators, and cross-functional partners, this individual guides members through the damage claim process and delivers actionable feedback through invoice audits and financial reviews.

Key Deliverables

• Serve as the vehicle damage subject matter expert by analyzing damage photos, member feedback, and vehicle damage estimates.
• Work with the data team to analyze trends and provide actionable feedback to reduce overall risk profiles and claims activity.
• Recommend improvements to policies and procedures to optimize workflow and train internal and external teams on tools and procedures.
• Monitor member behavior to identify bad actors or needed education and propose solutions.
• Guide members through the damage claim process and identify proactive measures to reduce member contact.
• Respond to member inquiries and escalated operational failures promptly and collaborate with Operations and Member Services teams to identify solutions.
• Assist the claims team with special projects including invoice audits, data collection, and financial reviews.

Skills & Qualifications

• Bachelor's degree preferred.
• 2 years of relevant experience in insurance, transportation, or logistics.
• Knowledge of Microsoft Office applications.
• Comfort working across multiple proprietary software systems.
• Excellent interpersonal, influencing, and process skills with the ability to communicate effectively at all levels.
• Ability to prioritize work independently, ensuring accuracy while meeting deadlines.

Reporting to a mentor and supervisor, the Claims Associate coordinates investigation, reserving, and documentation of low-exposure workers' compensation claims while developing proficiency across coverage, disability management, subrogation, and multi-jurisdictional compliance. Partnering with employers, medical providers, and adjusters, this individual builds foundational knowledge of the Workers' Compensation Act and Rules and Regulations across all assigned jurisdictions.

Core Responsibilities

• Maintain communication with employers, adjusters, and providers throughout the claims process.
• Conduct investigations of assigned workers' compensation claims and request medical notes, billing information, and other documentation to determine payment appropriateness.
• Timely and accurately reserve for assigned claims and document all medical notes and relevant communications in log notes.
• Discuss return-to-work status with employers and bill payment or reimbursement issues with employees.
• Identify potential subrogation claims and notify the appropriate supervisor.
• Work with mentor and supervisor to develop skills in coverage, disability management, medical management, litigation, subrogation, reserving, and settlement.
• Maintain and demonstrate knowledge of the Workers' Compensation Act and Rules and Regulations in assigned jurisdictions.

Requirements

• Adjuster license required or ability to obtain in assigned jurisdiction.
• No prior experience required.
• Functional understanding of basic medical terminology.
• Committed to increasing knowledge of workers' compensation law and regulations.
• Exceptional oral and written communication skills with superior organizational skills and attention to detail.
• Creative problem-solving skills with ability to manage multiple priorities and coordinate tasks.
• Self-motivated with the ability to work under general supervision.

Sitting at the intersection of finance and supply chain operations, the Claims Associate coordinates the resolution of complex customer deductions spanning OS&D, pricing discrepancies, and promotional claims through collaboration with Sales, Credit, and Supply Chain functions. Operating across the Claims and Deductions Ageing Report and the global Reason Code Methodology, this individual monitors the outstanding deduction balance for the customer portfolio and drives continuous improvement to eliminate repeated deduction trends.

Operational Focus

• Manage complex claims and deduction resolution, including over- and under-deliveries, through collaboration with Sales, Credit, and Supply Chain functions.
• Analyze customer claim details and determine claim validity in alignment with business policy, then reassign to the appropriate owner for next steps.
• Generate and review the Claims and Deductions Ageing Report and ensure all assigned claims and deductions are closed within predefined timeframes.
• Collaborate with Customer Solution Analyst on return-related claims and with OS&D on refusal-related claims, applying root cause reason codes following the global Reason Code Methodology.
• Provide 360-degree visibility on claim status to customers and internal teams and participate in operational reviews.
• Monitor outstanding deduction balance for the customer portfolio and drive continuous improvement to eliminate repeated deduction trends.

Background & Experience

• 2 years of experience in Accounts Receivable, Order Management, Distribution, Inventory Management, Transportation, or Demand and Supply Planning.
• Knowledge of OS&D, Pricing, Coupon Deductions, Promo, and other claim and deduction types.
• Proficiency in Microsoft Office including Word, Excel, and Outlook.
• Proficiency in SAP, BW, and Business Objects preferred.
• Excellent analytical aptitude with proven ability to analyze and interpret data.
• Strong problem-solving, decision-making, and communication skills with the ability to handle multiple priorities.
• Customer-centric mindset with strong relationship-building and continuous improvement orientation.

A key member of the finance and commercial operations team, the Claims Associate elevates trade claim accuracy by coordinating investigation, registration, and workflow-triggered resolution of deductions across Finance, Sales, and local Operations. Collaborating with collections teams, operational partners, and external customers, this individual maintains overall deduction balance targets and supports process and technology improvement initiatives.

Scope of Work

• Accurate and timely claim investigation by identifying relevant documentation for each claim type and sourcing through the right systems and channels.
• Escalate invalid claims to Collections where they translate into collectable amounts and proactively flag accrual gaps in SAP rebate agreements.
• Assist automated claim registration and validation and manually process claims, including collating back-up documentation in case of tool absence or failure.
• Trigger approval and resolution workflows per claim status and follow up as necessary, sending customer resolution communications with required documentation.
• Maintain regular contact with Finance, Sales, and local Operations to resolve disputes and recover invalid claims.
• Follow defined critical issue matrix, raise alerts when required, and maintain overall deductions balance targets.

Knowledge, Skills & Abilities

• Experience in Disputes Management with overall Bill to Cash knowledge and understanding.
• Knowledge of OS&D, Pricing, Coupon Deductions, Promo, and other deduction types.
• Good accounting skills, including budgeting, forecasting, and reconciliations.
• Advanced Excel skills and proficiency in Microsoft Outlook, PowerPoint, and MS Teams.
• Experience with customer business and trade term tools such as ACTPM CBP, Anaplan, and SAP.
• Exposure to technologies like Pega and HighRadius.
• Strong analytical skills with attention to detail.
• Proactive problem-solving mindset and customer-centric approach.
• English proficiency at B2 level or higher.

Accurate tracking and resolution of property claims depend on the Claims Associate, who reviews, logs, and coordinates all property incident reports daily while serving as liaison between properties, insurance brokers, carriers, and legal counsel. Serving as the operational point of contact for brokers, insurers, TPAs, and internal operations staff, this individual maintains the master claims database, tracks all filing deadlines, and ensures correspondence is distributed to all involved parties.

Activities

• Review, process, and log all property incident reports daily.
• Coordinate with necessary parties to determine if incidents should be submitted to the insurance company and submit claims when required.
• Manage relationships with third-party service providers including brokers, insurers, and TPAs.
• Educate, advise, and support operations staff on the claims process and protocol.
• Maintain continuous communication with all parties involved in property claims and distribute correspondence as needed.
• Compose letters and memos, prepare spreadsheets and reports, maintain the master database, and track claims to ensure deadlines are met.

Qualifications & Experience

• High school diploma or equivalent required with 2 years of administrative experience; Associate or bachelor's degree preferred.
• Claims processing, insurance experience, or litigation experience preferred.
• Experience handling General Liability, Workers' Compensation, and Property claims a plus nationally.
• Must be proficient in MS Word, MS Excel, MS PowerPoint, and MS Outlook, with MS Visio experience a plus.
• High ethical, compliance, and confidentiality standards with ability to manage confidential projects.
• Strong verbal and written communication, organizational, and proofreading skills.
• Ability to interact with leaders at all levels.

As the Claims Associate, this role guides coverage analysis and reserve management for fidelity and financial institution bond claims encompassing employee theft, funds transfer fraud, forgery, and computer fraud under the close supervision of a Claim Manager. The early career development program relies on this work to strengthen claims handling methodology, with the individual preparing coverage position letters, obtaining proofs of loss, and contributing process improvements across the casualty fidelity portfolio.

Accountabilities

• Receive assignments, review claim and policy information, conduct investigations, and determine extent of coverage under crime policies and financial institution bonds, including employee theft, funds transfer fraud, forgery, and computer fraud.
• Contact, interview, and obtain statements from insureds, witnesses, and law enforcement to secure necessary claim information.
• Evaluate facts from investigation to determine coverage and extent of the company's obligation under the policy contract.
• Prepare coverage position letters, set reserves within authority limits, and recommend reserve changes to the Claim Manager.
• Review claim progress and status with Claim Manager and assist in developing methods and improvements for handling claims.
• Settle claims promptly and equitably, obtain proofs of loss, releases, and assignments, and inform insureds or brokers of claim denials when applicable.

Required Qualifications

• Knowledge of the insurance industry and basic claims handling concepts, practices, and procedures.
• Strong analytical skills with detail orientation and ability to multitask and adapt to change.
• Basic proficiency in Microsoft Word, Excel, and Outlook.
• Strong communication skills including effective listening, written communication to varied audiences, and diplomatic expression of concerns.
• Excellent interpersonal and negotiation skills with the ability to work collaboratively and independently.
• Ability and willingness to travel.

Claims Associate determines jurisdiction and routes Workers' Compensation First Notice of Injury submissions from multiple intake sources, coding body parts, diagnoses, and causes of injury while confirming policy coverage and indexing documents to appropriate regions and departments. The work directly supports accurate claim setup across multiple states, with this individual maintaining department procedures, contributing to workflow development, and routing medical bill review documents to the appropriate vendor.

Key Responsibilities

• Enter and support priority and special requests, including correcting newly-created claims.
• Identify jurisdiction, date of injury, and special handling items, and research and re-index non-new claim submissions to route appropriately.
• Receive incoming new claims calls and serve as backup for ACD calls in the event of telephone system shutdown.
• Process Workers' Compensation claims from Open Pool queues or via telephone, coding body part, diagnosis, and cause of injury and confirming policy coverage.
• Maintain department procedures, working instructions, and job aids and participate in creating new workflows or workflow changes.
• Research multiple state and internal systems to route and index incoming mail, forward unidentified mail using appropriate form letters, and route documents to medical bill review vendor.

Experience & Qualifications

• High school diploma or GED.
• Insurance Institute of America coursework or other insurance-related education preferred.
• Minimum 2 years of general office or customer service experience.
• Knowledge of Workers' Compensation, insurance, medical terminology, and multi-state claims reporting processes.
• Basic knowledge of computers, spreadsheet software, word processing software, and document management systems with workflows.
• Excellent verbal and written communication skills, telephone etiquette, and ability to proofread for accuracy.
• Proven ability to multi-task, train others, and work independently.
• Ability to work varied hours and shifts.