CLAIMS INVESTIGATOR SKILLS, EXPERIENCE, AND JOB REQUIREMENTS

Updated: Nov 20, 2024 - The Claims Investigator must possess an adeptness for system and procedural improvements, continuously enhancing service for both internal and external clients. This role demands strong communication skills, capable of expressing ideas and resolving issues with clarity and precision, and requires proficiency in business correspondence across various management levels. Equipped with an analytical mindset, familiarity with forensic accounting, and proficiency in Excel, this position efficiently handles multitasking and prioritizing under pressing deadlines.

Essential Hard and Soft Skills for a Standout Claims Investigator Resume
  • Knowledge of Insurance Law
  • Claims Handling
  • Fraud Detection Techniques
  • Data Analysis
  • Interviewing Techniques
  • Report Writing
  • Regulatory Compliance
  • Risk Assessment
  • Financial Analysis
  • Use of Claims Management Software
  • Analytical Thinking
  • Attention to Detail
  • Communication Skills
  • Ethical Judgment
  • Problem Solving
  • Persistence
  • Adaptability
  • Empathy
  • Stress Management
  • Negotiation Skills

Summary of Claims Investigator Knowledge and Qualifications on Resume

1. BA in Criminal Justice with 2 years of Experience

  • Advanced proficiency in Microsoft Excel and Outlook.
  • Experience in a customer service position
  • Experience with JD Edwards and/or Insight 
  • Strong ethics and integrity
  • Excellent communication skills such as verbal, written, and presentation
  • Ability to handle multiple projects simultaneously
  • Strong organizational and technical skills
  • Effective time management and Professional Skills
  • Ability to learn and maintain confidentiality.
  • Detail-oriented and organized.
  • Excellent verbal and written communication skills.

2. BA in Legal Studies with 4 years of Experience

  • Able to improve systems or procedures, and continuous improvement in serving internal and external customers.
  • Excellent verbal and written communication skills 
  • Able to express ideas and communicate issues and problems thoroughly and concisely. 
  • Able to communicate thoughts completely and clearly. 
  • Use proper business email and letter format, with appropriate grammar and accurate spelling.
  • Ability to communicate with different levels of management
  • Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists
  • Ability to multi-task and prioritize and to work well under pressure with a sense of urgency and within time constraints
  • Familiarity with forensic accounting, claims documentation, or fraud investigation
  • Analytic mindset and good math skills.
  • Highly proficient in Excel and strong attention to detail

3. BA in Finance with 3 years of Experience

  • Experience in investigating, ex-police or ex-lawyer
  • Good on legal knowledge.
  • Good insurance knowledge.
  • Capable of establishing good contact with relevant authorities and organizations, in particular insurance investigators.
  • Time management skills.
  • Good communication and negotiation skills.
  • Ability to adapt quickly to any situation.
  • Organized with good time management skills.
  • Able to deal with people in a compassionate manner (some will be in difficult circumstances).
  • Good decision-maker, even under pressure.
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