| Detail | For this role |
|---|---|
| Department | Insurance |
| Level | Entry level |
| Reports to | Claims Manager |
| Direct reports | None |
| Experience | Fresher or up to 3 years in claims or customer service |
Claims Executive job description template
Copy this job description, replace the text in square brackets and post it on your careers page or a job portal.
Job title: Claims Executive
Department: Insurance
Reports to: Claims Manager
Location: [City], [office, branch or site]
About the role
A Claims Executive handles the intake and processing paperwork of insurance claims, registering claims, collecting documents, and following them through to settlement. The role reports to the Claims Manager. A good claims executive registers claims quickly, collects the right documents the first time so claims are not delayed, keeps the claimant informed, chases pending items and settlements, and keeps records clean so the claims team can decide and pay genuine claims fast without paperwork holding them up.
Key responsibilities
- Register incoming claims in the system with the correct details.
- Collect and check the documents needed to process each claim.
- Request missing documents clearly so claimants supply them the first time.
- Follow the claim through assessment, approval and settlement steps.
- Keep the claimant informed on the status of their claim.
- Chase pending documents, approvals and settlement payments until the claim is closed.
- Coordinate with surveyors, hospitals and third party administrators as each claim needs.
- Record claim decisions and reasons and file the documents.
- Resolve basic claimant queries and escalate the complex ones to the claims manager.
- Meet the claim intake and processing turnaround standards set for the team.
Requirements
- Graduate in any stream
- Good computer and communication skills
- Knowledge of insurance claims is an advantage
- Fresher or up to 3 years in claims or customer service
KRAs and KPIs for a Claims Executive
Key result areas for the appraisal form, each with a KPI you can measure every month or quarter.
| Key result area | How to measure it |
|---|---|
| Registration turnaround | Claims registered within the agreed time above the level set |
| Document completeness | Claims with complete documents at first pass above target |
| Processing turnaround | Claims moved through the steps within the agreed time |
| Claimant communication | Claimants updated within the agreed turnaround |
| Pending control | Pending claims kept below the agreed age |
| Record accuracy | Claim records complete and accurate above the agreed level |
Skills and tools
Tools used day to day: Claims management system, MS Excel, Document management tools, Call and messaging tools, Scanner.
Reporting line and career path
Next roles: Claims Manager, Health Claims Analyst, Claims Investigator
Interview questions for a Claims Executive
- How do you make sure a claim has all its documents at first pass?
- How do you keep a claimant informed through the process?
- How do you chase a pending settlement without annoying anyone?
- How do you handle a distressed claimant at intake?
- How do you keep claim records clean and complete?
- How do you prioritise when many claims come in at once?
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What does a Claims Executive do?
A Claims Executive handles the intake and processing paperwork of insurance claims. They register claims, collect and check documents, follow claims through assessment and settlement, and keep the claimant informed. They chase pending items and settlements and keep records clean so genuine claims are paid quickly.
What is the difference between a Claims Executive and a Claims Manager?
A Claims Executive handles registration, documents and follow up under guidance. A Claims Manager runs the team, decides harder cases, approves payments within authority and owns turnaround and leakage. The executive keeps claims moving; the manager makes the decisions and answers for the team.
How do you become a Claims Executive?
This is often an entry role for graduates with good computer and communication skills, and many start as freshers or from customer service. Knowledge of insurance claims helps. Employers value document discipline, follow up and empathy, since claimants are often dealing with a loss.