Job DescriptionThe
Claims Specialist is responsible for investigating, evaluating, processing, and resolving insurance or risk-related claims while ensuring compliance with company policies, contractual obligations, and regulatory requirements. This role serves as the primary point of contact for claimants, vendors, insurers, and internal stakeholders, providing timely and accurate claim administration from intake through resolution.
Key Responsibilities - Review, investigate, and process claims in accordance with established guidelines and service-level agreements.
- Gather and analyze supporting documentation, including incident reports, medical records, invoices, contracts, and legal documentation.
- Communicate with claimants, insurance carriers, attorneys, adjusters, and internal business partners.
- Determine claim validity, coverage, liability, and settlement recommendations.
- Maintain accurate claim files and documentation within claims management systems.
- Monitor claim reserves, payment activity, and case progress.
- Ensure compliance with applicable insurance regulations, company policies, and reporting requirements.
- Identify potential fraud indicators and escalate concerns as appropriate.
- Provide status updates and claim analytics to management and stakeholders.
- Support audits, litigation matters, and dispute resolution activities as needed.
Qualifications- Bachelor's degree in Business, Finance, Risk Management, Human Resources, or a related field, or equivalent experience.
- 2-5+ years of claims administration, insurance, risk management, workers' compensation, liability, or disability claims experience.
- Knowledge of insurance policies, claims investigation practices, and regulatory requirements.
- Strong analytical, negotiation, and problem-solving skills.
- Experience with claims management software and Microsoft Office applications.
- Excellent written and verbal communication skills.
Additional InformationThe salary range for this full-time role is $100K - $120K per year. Ranges are determined by role and level and represent a good faith effort to provide a fair and equitable salary. This range is a reflection of base salary only, not of a total compensation package. Please note Turner & Townsend reserves the right to pay more or less than the posted range, depending on candidate's experience and qualifications.
*On-site presence and requirements may change depending on our client's needs*Our inspired people share our vision and mission. We provide a great place to work, where each person has the opportunity and voice to affect change.
We want our people to succeed both in work and life. To support this we promote a healthy, productive and flexible working environment that respects work-life balance.
