Claim Representative I: This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion in the determination of compensability of claims.
Claim Representative I: This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion in the determination of compensability of claims.
Claim Representative I: This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion in the determination of compensability of claims.
Claim Representative I: This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion in the determination of compensability of claims.
Claim Representative I: This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion in the determination of compensability of claims.
Claim Representative I: This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion in the determination of compensability of claims.
Claim Representative I: This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion in the determination of compensability of claims.
Claim Representative I: This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion in the determination of compensability of claims.
Homeowner Claim Rep
Paramus, NJ ยท On-site
The claim representative will be responsible to receive the homeowner /property damage claim to include slip and falls, dog bites as well as storm damage, fire, water and theft and acknowledge.
Homeowner Claim Rep
Paramus, NJ ยท On-site
The claim representative will be responsible to receive the homeowner /property damage claim to include slip and falls, dog bites as well as storm damage, fire, water and theft and acknowledge.
Content Claim Representative/Senior Claim Representative
Cincinnati, OH ยท On-site
Medical
Dental
Vision
Retirement
PTO
Claim Representative Be here. Be great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American ...
Content Claim Representative/Senior Claim Representative
Cincinnati, OH ยท On-site
Medical
Dental
Vision
Retirement
PTO
Claim Representative Be here. Be great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group's member companies are subsidiaries of American ...
Claim Representative
Dallas, TX ยท On-site
Medical
Dental
Life
Retirement
PTO
Overview Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the desk or in the field ...
Claim Representative
Dallas, TX ยท On-site
Medical
Dental
Life
Retirement
PTO
Overview Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the desk or in the field ...
Claim Representative
Dallas, TX ยท On-site
Medical
Dental
Life
Retirement
PTO
Overview Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the desk or in the field ...
Claim Representative
Dallas, TX ยท On-site
Medical
Dental
Life
Retirement
PTO
Overview Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the desk or in the field ...
Property Claims Representative
Dallas, TX ยท Hybrid
Medical
Dental
Life
Retirement
PTO
Overview Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the desk or in the field ...
Property Claims Representative
Dallas, TX ยท Hybrid
Medical
Dental
Life
Retirement
PTO
Overview Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the desk or in the field ...
Requisition Claim Representative
Dallas, TX ยท On-site
Medical
Dental
Life
Retirement
PTO
Property Claim Representative Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the ...
Requisition Claim Representative
Dallas, TX ยท On-site
Medical
Dental
Life
Retirement
PTO
Property Claim Representative Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the ...
Property Claims Representative
Dallas, TX ยท Hybrid
Medical
Dental
Life
Retirement
PTO
Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the desk or in the field, visiting ...
Property Claims Representative
Dallas, TX ยท Hybrid
Medical
Dental
Life
Retirement
PTO
Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the desk or in the field, visiting ...
Claim Representative, Medical Only
Wall, NJ ยท On-site
$21 - $24/hr
Medical
Dental
Vision
Life
Retirement
PTO
Overview Claim Representative, Medical Only Location : Wall Township, NJ Schedule: In Office for training and eligible for hybrid Salary Range: $21.00/hr-$24.00/hr Build Your Career With Purpose at ...
Claim Representative, Medical Only
Wall, NJ ยท On-site
$21 - $24/hr
Medical
Dental
Vision
Life
Retirement
PTO
Overview Claim Representative, Medical Only Location : Wall Township, NJ Schedule: In Office for training and eligible for hybrid Salary Range: $21.00/hr-$24.00/hr Build Your Career With Purpose at ...
Claim Representative, Medical Only
$21 - $24/hr
Medical
Dental
Vision
Life
Retirement
PTO
Claim Representative, Medical Only Location : Wall Township, NJ Schedule: In Office for training and eligible for hybrid Salary Range: $21.00/hr-$24.00/hr Build Your Career With Purpose at CCMSI At ...
Claim Representative, Medical Only
$21 - $24/hr
Medical
Dental
Vision
Life
Retirement
PTO
Claim Representative, Medical Only Location : Wall Township, NJ Schedule: In Office for training and eligible for hybrid Salary Range: $21.00/hr-$24.00/hr Build Your Career With Purpose at CCMSI At ...
Property Claims Representative
Southington, CT ยท Hybrid
Medical
Dental
Life
Retirement
PTO
Overview Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the desk or in the field ...
Property Claims Representative
Southington, CT ยท Hybrid
Medical
Dental
Life
Retirement
PTO
Overview Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the desk or in the field ...
Property Claims Representative
Alpharetta, GA ยท Hybrid
Medical
Dental
Life
Retirement
PTO
Overview Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the desk or in the field ...
Property Claims Representative
Alpharetta, GA ยท Hybrid
Medical
Dental
Life
Retirement
PTO
Overview Under moderate supervision The Property Claim Representative is responsible for handling medium complexity commercial property claims. The adjuster will work from the desk or in the field ...
Claim Representative, Medical Only
Wall, NJ ยท On-site
$21 - $24/hr
Medical
Dental
Vision
Life
Retirement
PTO
Overview Claim Representative, Medical Only Location : Wall Township, NJ Schedule: In Office for training and eligible for hybrid Salary Range: $21.00/hr-$24.00/hr Build Your Career With Purpose at ...
Claim Representative, Medical Only
Wall, NJ ยท On-site
$21 - $24/hr
Medical
Dental
Vision
Life
Retirement
PTO
Overview Claim Representative, Medical Only Location : Wall Township, NJ Schedule: In Office for training and eligible for hybrid Salary Range: $21.00/hr-$24.00/hr Build Your Career With Purpose at ...
Claim Representative II - Casualty
Bakersfield, CA ยท Hybrid
$58K - $97K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Learn more about what it means to be a Claim Representative II - Casualty HERE! Benefits * Accrue twenty-one days of Paid Time Off during your first year * Up to eighty-seven percent of benefits are ...
Claim Representative II - Casualty
Bakersfield, CA ยท Hybrid
$58K - $97K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Learn more about what it means to be a Claim Representative II - Casualty HERE! Benefits * Accrue twenty-one days of Paid Time Off during your first year * Up to eighty-seven percent of benefits are ...
Claim Representative, Medical Only
Neptune City, NJ ยท On-site
$21 - $24/hr
Medical
Dental
Vision
Life
Retirement
PTO
Overview Claim Representative, Medical Only Location : Wall Township, NJ Schedule: In Office for training and eligible for hybrid Salary Range: $21.00/hr-$24.00/hr Build Your Career With Purpose at ...
Claim Representative, Medical Only
Neptune City, NJ ยท On-site
$21 - $24/hr
Medical
Dental
Vision
Life
Retirement
PTO
Overview Claim Representative, Medical Only Location : Wall Township, NJ Schedule: In Office for training and eligible for hybrid Salary Range: $21.00/hr-$24.00/hr Build Your Career With Purpose at ...
Claim Representative II - Casualty
Bakersfield, CA ยท On-site
$58K - $97K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Learn more about what it means to be a Claim Representative II - Casualty HERE! Benefits * Accrue twenty-one days of Paid Time Off during your first year * Up to eighty-seven percent of benefits are ...
Claim Representative II - Casualty
Bakersfield, CA ยท On-site
$58K - $97K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Learn more about what it means to be a Claim Representative II - Casualty HERE! Benefits * Accrue twenty-one days of Paid Time Off during your first year * Up to eighty-seven percent of benefits are ...
Claim Representative II - Casualty
Bakersfield, CA ยท Hybrid
$58K - $97K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Learn more about what it means to be a Claim Representative II - Casualty HERE! Benefits * Accrue twenty-one days of Paid Time Off during your first year * Up to eighty-seven percent of benefits are ...
Claim Representative II - Casualty
Bakersfield, CA ยท Hybrid
$58K - $97K/yr
Medical
Dental
Vision
Life
Retirement
PTO
Learn more about what it means to be a Claim Representative II - Casualty HERE! Benefits * Accrue twenty-one days of Paid Time Off during your first year * Up to eighty-seven percent of benefits are ...
Claim Representative information
See salary details
$11.54 - $14.31
4% of jobs
$14.31 - $17.09
14% of jobs
$18.17 is the 25th percentile. Wages below this are outliers.
$17.09 - $19.86
19% of jobs
The median wage is $21.67 / hr.
$19.86 - $22.64
21% of jobs
$22.64 - $25.42
14% of jobs
$26.53 is the 75th percentile. Wages above this are outliers.
$25.42 - $28.19
10% of jobs
$28.19 - $30.97
4% of jobs
$30.97 - $33.74
5% of jobs
$33.74 - $36.52
3% of jobs
$36.52 - $39.29
3% of jobs
$39.29 - $42.07
3% of jobs
$11
$24
$42
How much do claim representative jobs pay per hour?
What is a claim representative?
What are the key skills and qualifications needed to thrive as a claim representative?
What are some common challenges a claim representative might face, and how can they be addressed?
What is the difference between Claim Representative vs Claims Adjuster?
| Aspect | Claim Representative | Claims Adjuster |
|---|---|---|
| Required Credentials | High school diploma or equivalent; some roles may require insurance licenses | High school diploma; insurance licenses often required |
| Work Environment | Office settings, customer interactions, claims processing | Fieldwork and office work, investigating claims |
| Employer & Industry Usage | Insurance companies, government agencies | Insurance companies, third-party administrators |
Both Claim Representatives and Claims Adjusters work in the insurance industry, handling claims and assisting clients. Claim Representatives typically focus on customer service and initial claim processing, while Claims Adjusters investigate and evaluate claims, often in the field. Understanding these differences helps job seekers find roles aligned with their skills and credentials.
Do you need a degree to be a claim representative?
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Cities with the most Claim Representative job openings:
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For Claim Representative jobs, the most frequently searched job titles are:

Full-time
Re-posted 5 hours ago
Job description
SUMMARY:
Claim Representative I:
This is the entry level professional claim handler. Handles medical only and indemnity benefits. Exercises some discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority.
Claim Representative II:
This is the intermediate level of the claim handler career path. Handles moderate to difficult claims. Exercises progressively more discretion in the determination of compensability of claims. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority.
Claim Representative III:
This is the advanced level of the claim handler career path. Investigates claims and exercises significant discretion in the determination of compensability of claims. May handle large, more complex customers requiring high touch, labor intensive claim service. Considers many factors in the determination claim reserves. Negotiates and settles claims within given authority. Mentors lower level claim handlers. Coordinates special projects and provides guidance to others.
RESPONSIBILITIES/TASKS:
Claim Representative I, II, III:
- Verifies workers' compensation coverage of employers and injured employees.
- Determines compensability under workers' compensation by thorough investigation of the claim.
- Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits.
- Facilitates return to work for the injured employee.
- Establishes timely and appropriate reserves based on the profile of the claim within given authority based on anticipated financial exposure.
- Documents specifics of claims with potential for subrogation recovery, including amount of potential recovery monies.
- Manages medical bills for non-indemnity and indemnity claims directly associated with the claimed injury. Approves payment based on knowledge of the treatment plan and medical support showing relationship of treatment to the injury.
- Concludes and closes files following resolution of claims to meet internal performance standards while complying with state legislation to avoid penalties and manage expenses.
- Negotiates settlements with attorneys or injured parties within given authority at the earliest possible point to bring cases to final disposition.
- Works closely with manager on complex files or files above settlement/reserve authority.
- Manages outside vendors to ensure cost containment efforts.
- Establishes and maintains effective working relationships with all internal and external customers.
- Stays abreast of changes in workers' compensation statutes, case law and rehabilitation efforts/advancements in order to accurately interpret and apply relevant laws.
ADDITIONAL RESPONSIBILITIES/TASKS:
Claim Representative II, III:
- Administers complex claims and catastrophic exposures within authority, including claims from dedicated large accounts.
- Exercises independent judgment to settle cases prior to mediation or litigation.
- Actively participates in agent/client relationship management.
- Assists in mentoring team members.
Claim Representative III:
- Mentors team members.
- Conducts audits of claim files.
- Acts as a back up for team leader.
- Coordinates special projects.
This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.
EMPLOYMENT QUALIFICATIONS
EDUCATION OR EQUIVALENT EXPERIENCE:
Claim Representative I, II, III:
Bachelor's degree in a related field. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.
EXPERIENCE:
Claim Representative I:
Minimum one year relevant experience that provides the necessary skills, knowledge and abilities or completion of claims trainee program. Bilingual skills preferred.
Claim Representative II:
Three years experience in a workers' compensation claims environment which provides the necessary skills, knowledge and abilities, such as experience in reviewing, investigating and closing workers' compensation claims. Experience handling claims in multiple jurisdictions preferred. Bilingual skills preferred.
OR
One year of AF Group Claims Representative I experience that includes handling of difficult or complex claims.
Claim Representative III:
Five years experience in a workers' compensation claims environment which provides the necessary skills, knowledge and abilities, such as experience in reviewing, investigating and closing complex workers' compensation claims. Experience handling claims in multiple jurisdictions preferred. Bilingual skills preferred.
OR
Two years of AF Group Claims Representative II experience that includes discretion in determining compensability of complex claims and/or handling complex, high touch or labor intensive customers.
SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
Claim Representative I, II, III:
- Ability and proficiency in the use of computers and company standard software specific to position.
- Knowledge of medical and legal terminology related to the work.
- Knowledge of workers' compensation laws and regulations, including jurisdictional laws.
- Effective oral and written communication skills.
- Effective customer service skills.
- Ability to negotiate, build consensus and resolve conflict.
- Ability to manage multiple priorities and meet established deadlines.
- Attention to detail and analytical skills.
- Ability to work independently as well as within a team.
ADDITIONAL SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
Claim Representative II, III:
- Ability to make independent decisions.
- Ability to solve complex problems.
Claim Representative III:
- Ability to train and mentor others.
WORKING CONDITIONS:
Work is performed in an office setting with no unusual hazards. Minimal travel required.
PAY RANGE:
Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market, and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $56,700 and $94,900.
The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.
We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.
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About Emergent Holdings
Sourced by ZipRecruiter
Industry
Insurance services
Company size
501 - 1,000 Employees
Headquarters location
Lansing, MI, US
Year founded
2000