Job Description : Claims Analyst

Department: Claims Processing

Reports To: Claims Manager

Employment Status: Full-Time

Compensation: $50,000 – $70,000 per year, depending on experience and location


Position Overview :

The Claims Analyst is a critical member of the Claims Processing Department, responsible for reviewing, analyzing, and processing insurance claims. This role plays a key part in ensuring the timely and accurate settlement of claims, providing essential support to policyholders.


Key Responsibilities :

  • Review incoming insurance claims for completeness and accuracy.
  • Analyze claims to determine the extent of the insurance company’s liability.
  • Interact with policyholders, agents, and adjusters to obtain necessary documentation and information.
  • Calculate benefits payable and approve or deny claims based on the company’s policies and guidelines.
  • Work closely with the legal team in cases involving contested or complex claims.
  • Generate reports to track claims status, financial impact, and other key metrics.
  • Participate in audits and compliance checks as required.

Qualifications :

  • Bachelor’s degree in Business, Finance, or a related field.
  • Minimum of 2-4 years of experience in insurance claims or a similar analytical role.
  • Strong analytical, mathematical, and problem-solving skills.
  • Excellent verbal and written communication skills.
  • Proficiency in Microsoft Office Suite, especially Excel, and familiarity with claims software.

Benefits :

  • Comprehensive healthcare package, including medical, dental, and vision.
  • 401(k) retirement plan with company match.
  • Generous paid time off (PTO) and holidays.
  • Opportunity for performance bonuses and career advancement.

This job description provides a comprehensive outline of the responsibilities, qualifications, and compensation for the Claims Analyst role. Please note that the compensation range is a general estimate and may vary depending on the company’s size, location, and financial standing.