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Claims Adjuster

CRC Group
Flower Mound, USA
Full-time
Entry · 0–2 years experience
Onsite
Discovered 1 weeks ago

Full Job Posting

KEY RESPONSIBILITIES:

  • Following is a summary of the essential functions for this job. Other duties may be performed, both major and minor, which are not mentioned below. Specific activities may change from time to time.
  • Investigate and evaluate insurance claims to determine coverage and liability. • Review and interpret policy language and relevant documentation to assess claim validity. • Communicate with policyholders, agents, and external parties to gather required information. • Document all claim-related activities accurately in the system for record-keeping and regulatory compliance. • Negotiate settlements within established authority and escalate complex cases when necessary. • Provide exceptional customer service and maintain strong relationships with stakeholders. • Ensure compliance with state regulations and company procedures throughout the claims process.
  • Investigate and evaluate insurance claims to determine coverage and liability.
  • Review and interpret policy language and relevant documentation to assess claim validity.
  • Communicate with policyholders, agents, and external parties to gather required information.
  • Document all claim-related activities accurately in the system for record-keeping and regulatory compliance.
  • Negotiate settlements within established authority and escalate complex cases when necessary.
  • Provide exceptional customer service and maintain strong relationships with stakeholders.
  • Ensure compliance with state regulations and company procedures throughout the claims process.

EDUCATION AND EXPERIENCE

  • The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
  • Bachelor's degree or equivalent practical experience in insurance, risk management, or related field. • 0–2 years of experience in claims handling, insurance operations, or related role. • Familiarity with insurance policies, terminology, and claims processing systems.
  • CERTIFICATIONS / LICENSES / REGISTRATIONS
  • No specific criteria is required.
  • FUNCTIONAL SKILLS
  • Claims investigation and analysis • Policy interpretation • Negotiation and resolution skills • Regulatory compliance • Data entry and documentation accuracy • Customer service orientation • Time management and organizational ability • Effective written and verbal communication
  • General Description of Available Benefits for Eligible Employees of CRC Group: At CRC Group, we're committed to supporting every aspect of teammates' well-being – physical, emotional, financial, social, and professional. Our best-in-class benefits program is designed to care for the whole you, offering a wide range of coverage and support. Eligible full-time teammates enjoy access to medical, dental, vision, life, disability, and AD&D insurance; tax-advantaged savings accounts; and a 401(k) plan with company match. CRC Group also offers generous paid time off programs, including company holidays, vacation and sick days, new parent leave, and more. Eligible positions may also qualify for restricted stock units and/or a deferred compensation plan.
  • CRC Group supports a diverse workforce and is an Equal Opportunity Employer that does not discriminate against individuals on the basis of race, gender, color, religion, citizenship or national origin, age, sexual orientation, gender identity, disability, veteran status or other classification protected by law. CRC Group is a Drug Free Workplace.
  • EEO is the Law Pay Transparency Nondiscrimination Provision E-Verify
  • Bachelor's degree or equivalent practical experience in insurance, risk management, or related field.
  • 0–2 years of experience in claims handling, insurance operations, or related role.
  • Familiarity with insurance policies, terminology, and claims processing systems.
  • Claims investigation and analysis
  • Policy interpretation
  • Negotiation and resolution skills
  • Regulatory compliance
  • Data entry and documentation accuracy
  • Customer service orientation
  • Time management and organizational ability
  • Effective written and verbal communication

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