Pros and Cons of Becoming a Claims Representative
As a claims representative, you could make a good living while helping others and the profession typically has no formal education requirements. Check out the following pros and cons to see if this career could work for you.
| Pros of a Claims Representative Career |
|---|
| Above-average salary (about $63,500 mean salary in 2014)* |
| Minimal education and training requirements* |
| Help people recover from losses* |
| Wide range of job types (adjuster, appraiser, examiner, investigator)* |
| Cons of a Claims Representative Career |
|---|
| Low-growth field (3% growth from 2014-2024)* |
| May have to work evenings and weekends* |
| Limited job security (demand fluctuates)* |
| Potential hazards if inspecting damaged property or structures* |
Source: *U.S. Bureau of Labor Statistics.
Career Information
Job Description and Duties
As a claims representative, you'd work for a life, health or property insurance company reviewing loss and/or medical claims. Once a claim is submitted to an insurance company, you'd check to be certain that all guidelines are met and that the cost of the claim is covered by the claimant's policy. You might collaborate with legal counsel when reviewing and investigating claims, and you would need to maintain accurate records. If the claim is in order, it would be your responsibility to determine the appropriate amount to pay. With experience, some claims representatives are promoted to managerial or administrative roles with more responsibility.
Salary Info and Job Outlook
According to the U.S. Bureau of Labor Statistics (BLS), claims adjusters, investigators and examiners earned a mean annual wage of approximately $63,500 in May 2014 (www.bls.gov). The BLS projected that employment in this field would grow at a rate of three percent from 2014-2024, which was slower than average. The best job prospects were expected in the health insurance sector due to an aging U.S. population that will increase the number of claims filed. There may also be some growth in the property and casualty sector since there has been an increased number of natural disasters in recent years, which creates the need for more claims representatives.
Education and Licensing Requirements
Formal education isn't typically required to work as a claims representative. However, you might have to complete some courses to qualify for licensure. Additionally, some employers require that applicants pass written aptitude tests that measure communication, analytical and/or general math skills. Once on the job, you'd work under supervision, learning to do basic claims. With training and practice, you would work on more complicated claims.
Licensing requirements for claims representatives vary by state. You might have to meet education requirements, pass a licensing exam or both. However, if you're employed as a claims adjuster by a licensed insurance agency, you might not need to earn an individual license. If you do need licensure, continuing education likely will be required to maintain it.
Skills for Claims Representatives
Interpersonal and communication skills are essential for claims representatives since they work closely with clients and coworkers much of the time. In particular, active listening skills, empathy and objectivity are helpful when dealing with people who may be trying to cope with injury, illness or disaster. Problem-solving, decision-making, negotiating and math skills also are important abilities to cultivate for this profession.
Job Postings from Real Employers
When employers advertise for claims representatives, they typically seek out candidates for specific fields, such as automotive liability. In addition, many companies prefer candidates who have an understanding of local laws. Here are examples of what some real employers looked for during April 2012:
- An insurance company based in Massachusetts advertised for a workers' compensation claims representative with a bachelor's degree and 1-2 years of relevant work experience. Knowledge of state insurance policies, procedures and regulations was required.
- An insurance company in Virginia looked for a claims representative for automotive liability work. Candidates needed experience with preparing arbitration responses and settlement negotiations, as well as an understanding of state negligence laws.
- An insurance company in North Carolina was looking for a claims representative to review settled claims and report any errors, including overpayments or underpayments. This representative would work with legal counsel if litigation was required. Qualifications included at least a 2-year degree and a minimum of three years' experience.
- An Ohio medical insurance company sought a claims representative to process incoming claims as well as research and resolve pending claims. Though applicants needed only a high school diploma, the employer required successful completion of claims training programs and skills in Windows and keyboarding. Candidates were expected to be knowledgeable about various types of medical claims, including Medicare, prescription drug, vision and dental.
- An auto and home insurance company in Phoenix, Arizona, was seeking a claims representative to investigate and resolve claims involving collisions and third-party damage. This could include listening to recorded statements, reviewing professional estimates and appraisals, and negotiating settlements. A 4-year degree was required, and bilingual candidates in particular were encouraged to apply.
How Can I Stand Out?
Some companies might favor you as a job candidate if you have an undergraduate degree or insurance work experience. Additionally, employers often look for someone who has a background in the area in which they'll be working. For example, if you have experience in auto repair, it might give you an edge in getting work as an auto damage appraiser. If you have no experience but are drawn to this job, it may be worthwhile to attend an auto body repair program at a vocational school, according to the BLS.
Alternative Career Paths
Real Estate Appraiser/Assessor
If you like appraisal work but prefer not to be in an office all the time, you could become a real estate appraiser or assessor, estimating the value of real property, which consists of land and the buildings on it. You'll probably need an associate's or bachelor's degree, and the BLS reported a mean annual salary of about $54,000 for this job in 2011, which was less than the salary for a claims representative. However, the seven percent expected job growth from 2010-2020 is somewhat better than that for claims, and if you enjoy the independence of field work, the choice could be worth it.
Cost Estimator
If you like the analytical aspects of claims work but want to focus on projecting costs of things that have yet to be built, consider becoming a cost estimator. You'd work in manufacturing and construction, estimating what it would take to complete projects in terms of money, labor, time and materials. A bachelor's degree is usually required, along with solid math skills. According to the BLS, the median pay of a cost estimator in 2011 was roughly $63,000, and this career has a bright future, with much faster-than-average job growth of 36% projected for 2010-2020.
