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Claims Associate Jobs in Puerto Rico (NOW HIRING)

Oriental Bank

Associate, Retail Channels (Teller)

Dorado, PR · On-site

$14 - $17.50/hr

Receives claims or inquiries from customers or potential customers. Manages those within their ... Associate, technical degree or approved credits in Business Administration or related field ...

Grupo Triple-S

PR · On-site

$13 - $17.75/hr

... and claims processes applying various operational procedures and guidelines under general ... Associate's Degree in Business Administration or Marketing EXPERIENCE * Associate Degree in ...

Pharmpix

Benefit Business Support

Guaynabo, PR · On-site

Properly enter test claims to verify business rules set up in the system. * Perform quality ... Pharmacy Technician Associate Degree or equivalent professional experience. LICENSURE ...

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All JobsClaims Associate JobsClaims Associate Jobs in Puerto Rico

Claims Associate information

What does a claims associate do?

A claims associate handles claims for an insurance company. As a claims associate, your job duties may include reviewing a customer’s insurance coverage and interviewing those who have filed a claim. Your job is to ensure that a claim is processed correctly, so the customer receives the financial payout to which they are entitled. In this career, you usually work in an office, but you may need to travel to gather information about the claim. There are positions in every insurance industry so that you may work in anything from auto to life insurance. This position requires excellent research and interpersonal skills, and experience in customer service is a plus. Additional qualifications may include an associate degree.

What does a claims associate do?

A Claims Associate is responsible for reviewing, processing, and managing insurance claims submitted by policyholders. Their duties include verifying information, evaluating the validity of claims, and ensuring all necessary documentation is complete. They often communicate with customers, healthcare providers, or other parties to gather additional information and resolve any issues. Claims Associates play a crucial role in ensuring claims are processed accurately and efficiently according to company policies and regulatory guidelines.

What are the key skills and qualifications needed to thrive as a claims associate?

To thrive as a Claims Associate, you need a solid understanding of insurance policies, attention to detail, and basic analytical skills, usually supported by a high school diploma or equivalent. Familiarity with claims management systems, CRM software, and sometimes industry certifications like AIC (Associate in Claims) are commonly required. Strong communication, problem-solving, and customer service abilities set top performers apart. These skills are essential for accurately processing claims, ensuring compliance, and providing a positive experience for clients and policyholders.

What are some common challenges a claims associate may face, and how can they effectively handle them?

Claims Associates often encounter challenges such as managing a high volume of claims, navigating complex policy details, and communicating with clients who may be experiencing stress or frustration. Effectively handling these situations requires strong organizational skills, attention to detail, and clear, empathetic communication. Many Claims Associates find success by proactively prioritizing tasks, seeking guidance from senior team members when needed, and utilizing available technology to streamline documentation and follow-ups.

What is the difference between Claims Associate vs Claims Examiner?

AspectClaims AssociateClaims Examiner
Required CredentialsHigh school diploma or equivalent; some roles may prefer insurance-related certificationsHigh school diploma; insurance certifications like CPCU or similar beneficial
Work EnvironmentOffice setting, interacting with customers and internal teamsOffice setting, reviewing claims and documentation
Employer & Industry UsageInsurance companies, third-party administratorsInsurance companies, adjusting departments
Common Search & ComparisonClaims Associate vs Claims Examiner

The main difference between a Claims Associate and a Claims Examiner lies in their responsibilities. Claims Associates typically handle initial customer interactions and basic claim processing, while Claims Examiners review and assess claims in detail, often making determinations on claim validity. Both roles require similar credentials and work in comparable environments, but Claims Examiners usually have more specialized knowledge and decision-making authority.

Is being a claims associate hard?

Claims associates handle insurance claims processing, which requires attention to detail, strong communication skills, and knowledge of insurance policies. The job can be challenging due to the need for accuracy, meeting deadlines, and managing complex cases, but it is generally manageable with proper training and experience.

What is a claims associate in claims?

A claims associate is a professional who reviews, processes, and manages insurance claims to determine coverage and settlement amounts. They often work with claim documentation, use claims management software, and ensure compliance with company policies and industry regulations.
More about Claims Associate jobs

What are the most commonly searched types of Claims jobs in Puerto Rico?

The most popular types of Claims jobs in Puerto Rico are:

What are popular job titles related to Claims Associate jobs in Puerto Rico?

For Claims Associate jobs in Puerto Rico, the most frequently searched job titles are:

What job categories do people searching Claims Associate jobs in Puerto Rico look for?

The top searched job categories for Claims Associate jobs in Puerto Rico are:

Claims Associate jobs near you

Associate, Delinquency Management (Loss Mitigation) - Temporary

Oriental Financial Services LLC

San Juan, PR • On-site

$17.25 - $23.50/hr

Full-time

Posted 3 days ago

New

Job description

The Associate, Delinquency Management (Loss Mitigation) contributes to the success of Mortgage, Auto, and Consumer Loss Mitigation operations by ensuring system coding, payments, transmittals, solicitations, claims, invoices, and servicing requests are processed in accordance with investor and agency guidelines.
This role supports Loss Mitigation team members and business partners by maintaining operational accuracy, regulatory compliance, and service standards while helping deliver an exceptional customer experience. The position works on-site and is based at Oriental Center in San Juan, Puerto Rico.
MAIN DUTIES & RESPONSIBILITIES:
  • Maintain effective communication with investor representatives and service providers to ensure consultations, requests, and payments are processed timely and accurately.
  • Receive, review, analyze, and process Loss Mitigation vendor invoices, ensuring accuracy and preventing duplicate or incorrect payments.
  • Process required maintenance activities and reports through internal and external platforms in accordance with investor, agency, and regulatory requirements.
  • Ensure proper account maintenance, including system coding and account updates based on workout type and investor requirements.
  • Prepare, submit, and follow up on investor claims after Loss Mitigation alternatives are executed to ensure reimbursement of eligible funds and incentives.
  • Review and process Prepaid and Unapplied Funds reports in accordance with established procedures, including customer outreach when required.
  • Analyze loan accounts following the execution of Loss Mitigation alternatives and coordinate credit bureau corrections, fee adjustments, and related account updates, as applicable.
  • Support Loss Mitigation team members and other business units to ensure compliance with service standards, regulatory requirements, and operational objectives.
  • Prepare and distribute assigned reports, ensuring accuracy and compliance with established deadlines.
  • Other duties may be assigned.

MINIMUM REQUIREMENTS:
  • Associate degree in Business Administration, Finance, Accounting, or a related field required.
  • Two (2+) years of experience in Delinquency Management, Loss Mitigation, Default Servicing, Default Reporting, or related banking functions required.
  • Minimum education and experience requirements may be substituted with an equivalent combination of education, training, and relevant experience.
  • Broad knowledge of Loss Mitigation processes, Delinquency Management operations, and related servicing activities highly preferred.
  • Demonstrated ability to remain current with industry updates, investor requirements, and regulatory changes affecting Delinquency Management operations.
  • Experience processing invoices, claims, reimbursements, vendor payments, or investor remittance activities preferred.
  • Strong analytical, organizational, and problem-solving skills with attention to detail.
  • Proficiency in Microsoft Office applications, including Word and Excel, required.
  • Advanced written and verbal communication skills in Spanish required; proficiency in English desirable.
  • Ability to work independently, meet deadlines, collaborate effectively across business units, and maintain a high level of customer service.

WORK AUTHORIZATION & ELEGIBILITY:
  • Legally authorized to work in the US is required. This position is of indefinite duration and requires candidates to have permanent or ongoing work authorization.
  • Employee is responsible for maintaining eligible work authorization throughout his tenure with the organization.

Oriental is an Equal Opportunity Employer (EEO/Affirmative Action for Veterans/Workers with Disabilities)
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