Does anyone know what a Claims Representative does?

Question

I found a job for a claims representative for a medical insurance company in the paper, except it doesnt really give a good job decription. Does anyone know what they do?

Answer 1

You'd probably have written and telephone contact with those filing medical claims against an insurance company.

In a way, you'll be in the middle, between the claimant and the company with which you work, but your primary responsibility is to gather factual data of each claim, insure that all the paperwork is complete and signed, and then submit it to your supervisor for approval or rejection.

Years ago I worked as a claim representative for a major bank in Little Rock. It was in the "Loss Draft" department wherein people would call in to file a claim because of house damage--roofs, floods, fires, etc.--. I did it all, securing approvals or denials from my supervisor case-by-case.

The people filing the claims will be, in a way, at your mercy and are fully cognizant of the fact that you and what you do will be their ticket for compensation. You must be fair, warm, but loyal to your company at the same time.

You also will meet many great people during this job, but you'll also contend with some anal orifices along the way.

If you enjoy communications via phone and letter and have expertise in the written word and intelligent communications then working as a claims representative might be for you.

Good luck.