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Direct Claims Jobs in Rhode Island (NOW HIRING)

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

Claims Unit Manager

ACSC Management Services Inc

Providence, RI • Remote

$120K - $160K/yr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 7 days ago

Job description

Claims Unit Manager

Job Summary


This management leadership position is typically responsible for managing four to ten Claims Teams, or it can manage specialized functions within the Claims business unit. The primary functions include effective loss and expense management, employee development and succession planning, training, staffing, performance measurements and continuous improvement. Another critical function is to facilitate unit level strategies to support claims initiatives. The position also ensures compliance with all regulatory and statutory requirements as well as company technical and customer service Best Practices.
Job Duties

  • Ensure all claims within the unit meet or exceed quality and regulatory requirements. Regularly review appropriate claim files for quality and monitor results of all audits, performance reports and customer survey data. Ensure corrective actions are taken to correct deficiencies.

  • Recruit and develop people to accomplish #1. Effectively oversee/participate with management team in employee recruitment to ensure appropriate staffing. Identify and implement staff development and training needed to support an effective succession plan. Perform timely and responsive employee coaching and performance counseling.

  • Provide opportunities, support professional growth and expand staff responsibilities. Delegate authority to appropriate levels. Capitalize on capabilities of all employees and ensure decisions correlate with corporate and Claim Division goals.

  • Communicate corporate, unit, and team goals with direct reports. Monitor and reinforce behavior that furthers technical and customer service performance expectations. Continuously seek innovative approaches to address organizational issues.

  • Ensure effective communication by the unit management team with internal and external customers. Communicate and interact with a variety of individuals to address customer service issues in a prompt and professional manner

  • Prepare reports and statistical data on behalf of department regarding performance, cost, staffing, and resource allocation. Attend meetings, both intra and inter-department, to evaluate work product, case management system and overall administrative projects

  • Participate in committees and projects designed to enhance the organization’s goals and objectives.


Qualifications

  • Bachelors Equivalent combination of education and experience Preferred

  • 7-9 years Claims handling and/or operations. Required

  • 4-6 years Management/Supervisory Preferred

  • Advanced organizational and planning skills required.

  • Advanced oral and written communication skills required.

  • Advance interpersonal skills necessary

  • Ability to effectively lead change.

  • Valid Driver's License, acceptable Department of Motor Vehicles record and minimum liability insurance - Issued by State Required

  • Chartered Property Casualty Underwriter - Insurance Institute of America Required


Travel Requirements

  • Occasional travel to off-site business meetings or conferences.

The starting pay range for this position is:

$120,500.00 - $160,800.00

Additionally, you will be eligible to participate in our incentive program based upon the achievement of organization, team and personal performance.

Remarkable benefits:
•    Health coverage for medical, dental, vision

•    401(K) saving plans with company match AND Pension    

•    Tuition assistance

•    Floating holidays and PTO for community volunteer programs

•    Paid parental leave

•    Wellness programs

•    Employee discounts (membership, insurance,

travel, entertainment, services and more!)

Auto Club Enterprises is the largest club within the national AAA federation. We have nearly 17,000 employees in 24 states helping more than 18 million members. The strength of our organization is our employees. Bringing together and supporting different cultures, backgrounds, personalities, and strengths creates a team capable of delivering legendary, lifetime service to our members. When we embrace our diversity – we win. All of Us! With our national brand recognition, long-standing reputation since 1900, and constantly growing membership, we are seeking career-minded, service-driven professionals to join our team.

"Through dedicated employees we proudly deliver legendary service and beneficial products that provide members peace of mind and value.”

AAA is an Equal Opportunity Employer

Our organization participates in E-Verify

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