This post presents complete information on the job description of insurance claims assessors to help you gain deep understanding of what they do, as well as templates employers can use.
It highlights the key tasks, duties, and responsibilities that commonly make up the insurance claims assessor work description in most organizations.
This article also presents major requirements that anyone seeking to work as an insurance claims assessor will need to meet to qualify for hiring.
What Does an Insurance Claims Assessor Do?
Insurance claims assessor is responsible for overseeing the entire claims assessment process, including benefit explanation.
He/she is responsible for clerical functions and other necessary duties that are associated with insurance transactions.
In other words, an insurance claims assessor refers to one who is professionally saddled with the responsibility of conducting investigations into insurance claims in order to ensure their validity.
His/her job description entails examining, inspecting, and assessing the damage and loss of insured properties and businesses; estimating insurance costs and inspecting insured properties in order to evaluate the conditions that affect underwriting standards.
Furthermore, in the process of disseminating his or her duties, an insurance claims assessor is expected to carry out several important daily activities, such as analyzing claims in order to determine the level of the organization’s liability, making approval or denial decisions regarding claims, and negotiating settlements with claimants in accordance with provided policy or guidelines.
An insurance claims assessor may also be responsible for liaising or collaborating with insurance agents, and interviewing claimants in order to correct errors, rectify omissions, and carry out investigations in order to resolve questionable issues.
An insurance claims assessor may also carry out functions that are associated with insurance transactions, such as responding to claims in a timely manner, filing paperwork, communicating with policyholders, investigating liabilities, notifying the insurer of a covered loss as defined under the insurance policy, and assessing damages.
The insurance claims assessor work description also involves researching, detailing, and substantiating each part of a claim, including building damage, contents, and extra living expense claims; preparing detailed damages reports based on monthly insurance cost software for the purpose of making an offer of settlement to the insured.
It also entails protecting the interest of the insurance company when dealing with claimants, and ensuring accurate procedures.
The role of an insurance claims assessor requires the ideal candidate or any interested individual to possess and demonstrate certain required skills or attributes, such as good verbal and written communication skills, sound mathematical skills, well-developed interpersonal skills, computer proficiency, high analytical mind, ability to pay particular attention to details, and several other skills.
Insurance Claims Assessor Job Description Example/Sample/
Some of the major duties, tasks, and responsibilities that usually make up the insurance claims assessor job description are as follows:
- Obtaining all necessary information on claims for the purpose of completing processing
- Uncovering fraudulent claim scheme
- Assisting underwriters and insurance agents in the field to investigate claims and determine the cost and extent of damages
- Developing and maintaining a strong understanding of insurance policies and legal issues
- Inputting claims into the computer system accurately
- Contributing to the continuous development of the claims process by identifying and implementing several opportunities for the development of products and process improvement
- Suspending claims that require further investigation in order to resolve them appropriately
- Proactively seeking to clarify and resolve claims using the best method of communication and initiative
- Responding to all relevant incoming correspondence and queries from the company’s internal departments
- Working on a shift basis as required by the organization
- Protecting the interest of the insurance company when dealing with claimants.
Insurance Claims Assessor Requirements – Skills, Knowledge, and Abilities for Career Success
If you are seeking to work in the role of insurance claims assessor, the requirements most recruiters will want you to meet include the following:
- High analytical skills to critically analyze and examine damages, and conduct investigations
- Good mathematical skills to effectively assess damages
- Well-developed written and oral communication skills to effectively talk to claimants and interview witnesses, and also report to the upper management of the insurance company
- Strong and particular attention to detail to analyze property damages in order to find hints that might be hidden
- Computer proficiency to work effectively with certain assessment tools or software
- Several years of proven work experience either professionally or through an internship
- A Bachelor’s degree in any insurance or business related field.
Insurance Claims Assessor Job Description Templates
Here are insurance claims assessor job description templates employers can simply edit and use in their job postings to attract the best talents to their companies:
TEMPLATE 1.
Position Title: Insurance Claims Assessor
Reports To: Claims Manager / Claims Supervisor / Senior Claims Analyst
Location: [Your Company Location]
Employment Type: Full-Time
Company Overview
[Your Company Name] is a reputable insurance provider dedicated to delivering accurate, fair, and timely claims processing services. We support policyholders with integrity, professionalism, and compassionate service during times of loss. Our team values accuracy, compliance, and customer-focused claims management.
Position Overview
We are seeking a detail-oriented and analytical Insurance Claims Assessor to evaluate and process insurance claims efficiently and accurately. The Claims Assessor reviews documentation, verifies coverage, investigates claim validity, determines settlement amounts, and ensures compliance with company policies and legal regulations.
The ideal candidate has strong analytical skills, excellent communication abilities, and experience in claims assessment or insurance operations.
Key Responsibilities
Claims Evaluation & Processing
- Review and assess new claims to determine coverage eligibility and policy compliance.
- Examine claim forms, documentation, medical reports, police reports, and supporting evidence.
- Determine validity of claims and calculate appropriate settlement amounts.
Investigation & Verification
- Conduct investigations through interviews, phone calls, written correspondence, or field inspections.
- Verify claimant identity, policy details, and accuracy of submitted information.
- Identify potential fraud indicators and escalate suspicious cases when necessary.
Communication & Customer Service
- Communicate claim decisions, required documentation, and next steps to policyholders.
- Provide clear explanations regarding coverage, claim status, and settlement outcomes.
- Handle inquiries and resolve customer concerns professionally and efficiently.
Documentation & Recordkeeping
- Maintain accurate, organized records of claims, communications, and investigation findings.
- Enter claim data into claims management software and update statuses regularly.
- Produce detailed reports for supervisors or auditors as required.
Collaboration & Coordination
- Work closely with underwriters, adjusters, medical providers, legal teams, and third-party vendors.
- Coordinate with internal departments to gather information and finalize claims.
- Support senior claims staff during high-volume periods or complex cases.
Compliance & Quality Assurance
- Ensure all claim decisions follow company guidelines, insurance laws, and state/federal regulations.
- Follow internal auditing procedures and quality metrics.
- Participate in ongoing training to stay updated on insurance policy changes and regulatory requirements.
Skills & Qualifications
- Strong analytical and critical-thinking skills.
- Excellent communication, customer service, and negotiation skills.
- Ability to review complex documents and make accurate decisions.
- High attention to detail and strong organizational skills.
- Proficiency with claims management software, CRM tools, and Microsoft Office.
- Ability to work efficiently in a fast-paced, deadline-driven environment.
- Knowledge of insurance terminology, claims processes, and industry regulations preferred.
Education & Experience Requirements
- High school diploma or GED required; associate or bachelor’s degree in Business, Insurance, Finance, or related field preferred.
- 1–3 years of experience in insurance claims processing, underwriting support, or customer service in the insurance industry.
- Certifications such as AIC (Associate in Claims) or CPCU coursework are a plus but not required.
Eligibility to Work in the United States
Applicants must be legally authorized to work in the United States without requiring employer-sponsored work authorization now or in the future.
Work Environment
- Office-based or remote work environment depending on company structure.
- Requires frequent computer work, reviewing documents, and communicating with clients.
- May involve occasional travel for field visits, meetings, or training sessions.
Equal Opportunity Statement
[Your Company Name] is an Equal Opportunity Employer. We welcome applicants regardless of race, color, religion, gender identity, age, national origin, disability, sexual orientation, veteran status, or any protected characteristic.
Additional Information
- Duties may vary based on claim type (health, auto, property, life, disability, etc.).
- Reasonable accommodations may be offered to qualified individuals with disabilities.
- Pre-employment background checks may be required.
- Training will be provided on claims systems, compliance, and company policies.
How to Apply
Submit your resume and application to [Insert Application Email or Job Link].
TEMPLATE 2.
Location: [City, State]
Employment Type: Full-Time
About Us
[Your Company Name] is a trusted insurance provider committed to delivering fair, accurate, and timely claims processing. We are seeking a detail-oriented Insurance Claims Assessor to join our team.
Job Summary
The Insurance Claims Assessor reviews and processes insurance claims, verifies coverage, investigates claim details, and determines appropriate settlement amounts. This role ensures compliance with company policies and provides excellent support to policyholders throughout the claims process.
Key Responsibilities
- Evaluate new claims for coverage eligibility and policy compliance
- Review claim forms, supporting documents, and evidence
- Conduct investigations and verify claim details
- Determine claim validity and calculate settlement amounts
- Communicate decisions and next steps to policyholders
- Maintain accurate documentation in claims management systems
- Collaborate with underwriters, adjusters, and internal teams
Qualifications
- 1–3 years of experience in insurance claims, underwriting, or related fields
- Strong analytical, communication, and customer service skills
- Ability to review detailed information and make accurate decisions
- Proficiency with claims software and Microsoft Office
- Knowledge of insurance processes and regulations preferred
Eligibility to Work in the U.S.
Applicants must be legally authorized to work in the United States.
How to Apply
Submit your resume to [Insert Email or Application Link].
Insurance Claims Assessor Job Description for Resume
If you have worked before as an insurance claims assessor or are presently working in that’ role and are writing a new resume, you can quickly and conveniently make the professional experience part of the resume by applying the sample insurance claims assessor job description provided above.
Using the above job description in highlighting the duties and responsibilities you have carried out as an insurance claims assessor will certainly give your resume a boost, especially if to be effective on the new job requires some insurance claims assessor working experience.
(Learn how to make an effective resume applying the Employer-focused Resume Writing Technique)
Conclusion
If you are an employer or recruiter needing to hire for the insurance claims assessor role in your organization, you will need to provide a detailed description of the job to inform prospective applicants about the duties and responsibilities they will be expected to perform if hired.
You can quickly make such description by applying any of the insurance claims assessor job description templates above.
This post is also useful to individuals interested in the insurance claims assessor career, to learn and gain huge knowledge of the role.
