What does a Claims Representative do?

Claims representatives work for insurance companies to settle claims through the evaluation of facts of a customer's situation surrounding their claim. They are responsible for determining whether the loss is covered and what compensation should be. They investigate thoroughly to ensure that an insurance claim is not fraudulent and may be required to contact relevant third-parties including a doctor, an employer, or to consult with a police report. Ultimately, claims representatives negotiate insurance settlements, authorize payments, and keep records.

Claims representatives serve as the liaison between a policyholder and an insurance specialist and are often the initial point person for insurance-related events. In some instances, they collaborate with representatives from other insurance companies for an incident that is relevant to both industries, including medical and automotive carriers. Claims representatives need a minimum high school diploma or GED and complete a college degree program that provides academic training for the vocation. Professional certification is also available.

Work/Life Balance
3.3 ★
Salary Range--
Career Opportunity
3.2 ★
Avg. Experience8+ years

Claims Representative Salaries

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Glassdoor Estimated Salary

Claims Representative Career Path

Learn how to become a Claims Representative, what skills and education you need to succeed, and what level of pay to expect at each step on your career path.

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Claims Representative Insights

Read what Claims Representative professionals have to say about their job experiences and view top companies for this career.
Safety Engineering Consultants
Claims Representative
20 Oct 2021

“Salary was pretty good but not super competative but profit sharing one a year was nice perk”

State FarmState Farm
Claim Associate
21 Jun 2021

“Great training and resources will be setup to do your job with confidence and continuous improvement.”

Sedgwick Claims Management ServicesSedgwick Claims Management Services
Senior Claims Representative
11 Aug 2021

“we are told to do many things ourselves that are really tasks for support staff.”

Respiratory Technologies
Reimbursement Specialist
16 Mar 2021

“There is no coaching or career development whatsoever (even though they advertise this as an employee benefit).”

State FarmState Farm
Claim Associate
6 Oct 2020

“Very little information was ever communicated to me about when I could possibly get a better job.”

Claims Representative
14 Oct 2021

“I worked my whole life in the service industry and this was my first opportunity to work a "9”

AllianceRx Walgreens PrimeAllianceRx Walgreens Prime
Insurance Specialist
29 Jun 2020

“I had to train others and was given no option not to and no pay incentive”

Social Security AdministrationSocial Security Administration
Claims Representative
31 Mar 2021

“Do not look at this as a career and you’ll be happy and healthy.”

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Claims Representative Interviews

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