Claims & Insurance Specialist

Key Responsibilities

• File and manage auto and injury insurance claims with first- and third-party carriers within 24–48 hours of the introductory call, ensuring compliance with firm timelines and insurance requirements.
• Send Letters of Representation (LOR) to applicable insurance carriers and follow up to obtain Letters of Acknowledgment (LOA).
• Track and confirm liability status for each claim and follow up with insurance adjusters as needed to maintain timely determinations.
• Request, obtain, and process critical documentation including police reports, Open Records Requests (ORR), and driver’s records when applicable.
• Accurately upload and document all claim-related information in the case management system to support Prelitigation Paralegals and legal teams in case preparation.
• Contact health insurance carriers to verify active coverage related to the date of loss.
• Notify and follow up with subrogation departments to identify, verify, and document medical liens associated with the claim.
• Request denial or no-coverage letters from insurance carriers when coverage cannot be confirmed.
• When applicable, contact child support offices to verify the existence of active child support liens and document responses.
• Maintain detailed claim logs and ensure all follow-ups are completed within required timeframes.
• Communicate claim status updates weekly with case managers, prelitigation paralegals, and/or attorneys to ensure alignment and case momentum.

KPIs / Performance Metrics

• Claim filing completion within 48 hours of client introduction (≥ 95%).
• LOR and LOA tracking accuracy logged per case (100%).
• Liability confirmation obtained within 10 business days of claim filing.
• Coverage verification and lien confirmation accuracy (≥ 98%).
• No missed follow-ups older than 7 days on any active claim.
• Weekly claim status reports submitted on time (100%).