Claims Specialist

Position Summary / Purpose

Responsible for negotiating and settling claims submitted to the carrier. Works cross-departmentally to ensure strategic alignment, optimal settlements, and strong carrier relationships. Adapts negotiation strategies based on carrier behavior and claim complexity, and contributes to process improvements within the Billing Department.

• Negotiate and settle water mitigation claims.
• Collaborates closely with the Collections (AR) and Estimating departments to align claim strategy.
• Reports directly to the Billing Director regarding complex or unconventional claim issues.
• Maintains consistent, professional communication with carriers and their representatives.
• Adapts negotiation tactics based on carrier trends, scope discrepancies, or job complexity.
• Tracks claim outcomes and contributes to ongoing departmental process improvements.
• Capable of performing all Estimator-level duties as needed.

• Negotiation & Persuasion Skills – Effectively communicates and justifies estimates to achieve fair and accurate settlements.
• Responsiveness & Sense of Urgency – Maintains timely communication with carriers and internal teams to keep claim negotiations progressing.
• Strategic Thinking & Adaptability – Adjusts approach based on carrier behavior and zooms in/out between details and overall claim strategy.
• Professional Communication – Crafts persuasive, professional written correspondence and maintains composure during complex negotiations.
• Attention to Detail – Reviews comparatives, scope items, and line-by-line feedback to identify errors or missed opportunities.
• Team Collaboration – Coordinates closely with AR, Estimating, and Claims Handler roles to ensure unified execution.
• Accountability & Initiative – Owns claim outcomes and proactively resolves roadblocks without excessive oversight.
• Technology – Proficient in Xactimate, CRM, Google (email, drive, chat, etc), Matterport, and standard communication.

• Language
  
  Skills:
  
  Ability to write and speak clearly in professional communications with clients, carriers, and team members.
• Mathematical
  
  Skills:
  
  Basic understanding of units, rates, and ratios to support scope reconciliation.
• Reasoning Ability: Can interpret written estimates, comparatives, and apply judgment in common claim scenarios.
• Computer
  
  Skills:
  
  Intermediate proficiency with Xactimate, Gmail, Google Drive, CRM, and spreadsheets.
• Certifications
  
  Required:
  
  IICRC WRT and ASD