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Direct Claims Jobs in Hawaii (NOW HIRING)

Progressive

Claims Specialist Lead

Honolulu, HI · Hybrid

$88K - $115K/yr

Ability to direct the use of discovery tools such as interrogatories, depositions and production of document * 3 years of Casualty and Litigation claims handling experience Compensation * Based on ...

HDR

Construction Claims Manager/Consultant

Honolulu, HI · On-site

Manage the local rail program's construction claims program under the supervision of the Director of Construction Claims, Utility and Third Party. * Responsible for claims avoidance, identification ...

Progressive

Claims Adjuster Senior - Injury

Honolulu, HI · Hybrid

$80K - $105K/yr

Ability to direct the use of discovery tools such as interrogatories, depositions and production of document * Two years Auto Injury Claims handling experience Compensation * Based on location and ...

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Direct Claims information

What is a direct claim?

Direct claims refer to insurance claims that are filed directly by the policyholder with their own insurance company, rather than going through a third party or the at-fault party's insurer. This process is common in situations like auto accidents, where the policyholder seeks compensation for damages or losses under their own policy. Direct claims help streamline the process, reduce delays, and ensure the policyholder receives prompt assistance and settlements. They are often associated with 'first-party' insurance coverage, such as collision, comprehensive, or health insurance claims.

Can you work remotely in direct claims jobs?

Many direct claims jobs offer remote work options, especially for roles involving claims processing, customer service, or administrative tasks. Employers may require familiarity with claims management software and good communication skills, and remote positions often involve standard office hours and secure internet connections.

Do I need a degree to be a direct claims specialist?

A degree is not typically required to become a direct claims specialist, but relevant experience, knowledge of insurance policies, and strong communication skills are important. Many employers provide on-the-job training and may prefer candidates with a high school diploma or equivalent. Certifications in insurance or claims processing can enhance job prospects.

What are some common challenges faced by professionals in direct claims roles, and how can they effectively manage these challenges?

Professionals in Direct Claims often face the challenge of balancing a high volume of claims with the need for thorough investigation and timely resolution. Managing customer expectations and handling sensitive situations, such as denied claims or complex cases, can also be demanding. Effective communication, strong organizational skills, and staying updated on policy guidelines are crucial for success. Building collaborative relationships with adjusters, underwriters, and other departments helps ensure accurate and efficient claims processing.

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

To thrive as a Direct Claims Specialist, you need a solid understanding of insurance policies, claims processes, and relevant legal regulations, often supported by a degree in business, finance, or a related field. Familiarity with claims management software, customer relationship management (CRM) systems, and sometimes industry certifications like AIC or CPCU is typical. Exceptional attention to detail, problem-solving abilities, and strong communication skills set top performers apart in this role. These skills and qualifications ensure claims are processed accurately and efficiently, leading to customer satisfaction and minimized risk for the insurer.

What is the difference between Direct Claims vs Claims Adjuster?

AspectDirect ClaimsClaims Adjuster
CredentialsInsurance license, knowledge of policiesInsurance license, sometimes certifications like AIC or CPCU
Work EnvironmentCustomer service, office or remoteFieldwork, office, or remote
Employer & IndustryInsurance companies, agenciesInsurance companies, third-party administrators
Search & Comparison IntentUnderstanding direct claims handlingEvaluating claims adjustment roles

Direct Claims professionals primarily handle claims directly from policyholders, focusing on processing and resolving claims within the insurance company. Claims Adjusters evaluate, investigate, and settle claims, often working in the field or remotely. Both roles require insurance licensing, but Claims Adjusters may have additional certifications. While their work overlaps in claims processing, Direct Claims roles are more customer-facing, whereas Claims Adjusters focus on assessment and negotiation.

What are popular job titles related to Direct Claims jobs in Hawaii? For Direct Claims jobs in Hawaii, the most frequently searched job titles are:
What job categories do people searching Direct Claims jobs in Hawaii look for? The top searched job categories for Direct Claims jobs in Hawaii are:
What cities in Hawaii are hiring for Direct Claims jobs? Cities in Hawaii with the most Direct Claims job openings:
Direct Claims jobs near you

Claims Liaison Specialist

Hawaii Medical Service Association

Honolulu, HI • Hybrid

Full-time

This job post has expired 1 day ago. Applications are no longer accepted.

Job description

  1. Function as a central communication point between claims processing teams and internal/external partners regarding claim status, issues and resolutions.
  2. Investigate and resolve escalated claims and trends, including denied or delayed claims, by coordinating with relevant departments to implement short- and long-term solutions and process improvements.
  3. Manage open claims issues to ensure timely resolution in compliance with internal SLAs and regulatory standards.
    Collaborate with internal teams to conduct training sessions and measure effectiveness of training.
  4. Provide support for audits, appeals, and compliance-related activities
  5. Participate in system updates, and cross-functional meetings to stay current on claims processing procedures and benefit plan designs.
  6. Document all interactions, updates, and outcomes clearly in case management or claims systems.
  7. Performs all other miscellaneous responsibilities and duties as assigned or directed

#LI-Hybrid

  1. Associates degree and two years of related work experience; or equivalent combination of education and related work experience.
  2. Effective written and verbal communication skill, including the ability to communicate and present complex issues in a concise and easy to understand manner.
  3. Knowledge of process improvement methodologies.
  4. Knowledge of methodologies for driving increased operational quality.
  5. Intermediate knowledge of Microsoft Office applications including, but not limited to Word, Powerpoint, Outlook and Excel.

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