Claims Setup Specialist

We are looking for a detail-oriented and organized individual to join our team as a Claims Setup Specialist. This entry-level role is focused on the initial setup of claims, ensuring all information is accurately entered into the claims management system. You will play a key role in preparing claims for further processing by entering data, verifying policy details, and assigning claims to the appropriate adjusters. This position is a full-time, in-office position located at our Rutherford, NJ, headquarters.

Key Responsibilities:

• Initial Claims Setup:
• Review FNOL (First Notice of Loss) and ensure all necessary information is included (claimant info, loss date, incident description)
• Enter claim details into the system, including policy info, loss type, incident description, and the claimant’s description of the event
• Policy Verification:
• Cross-check claim details against the policy to verify effective dates of coverage
• Confirm policy and coverage details are accurately entered into the system
• Confirm appropriate client contact is attached to the policy
• Assign Adjuster & Set Diary Notifications:
• Assign the claim to the appropriate adjuster and supervisor
• Set adjuster diaries with new claim notifications and necessary actions
• Claims Acknowledgement Letters:
• Generate and send acknowledgement letters as per client instructions

Skills and Qualifications:

• High attention to detail for accurate data entry and policy verification
• Ability to assign claims and set appropriate reminders
• Familiarity with claims management systems (or willingness to learn)
• Basic insurance knowledge is a plus but not required
• Strong organizational and time management skills
  
  

Company Overview:

Raphael & Associates is a third-party claims administrator and independent claims adjusting company internationally recognized for exceptional service. We understand the importance of adapting to the demands of a dynamic market and we tailor our services to our client’s specific needs. As a claim’s organization, what we do is complex. Our mission is simple: to provide outstanding service, retain extraordinary professionals, and utilize the best technology in the industry!

As a leading organization in the industry, we offer dynamic and challenging opportunities to individuals who want to make a difference. We value camaraderie, vision, a passion for excellence, creativity, and a “roll-up-your-sleeves, get it done” mentality. We are searching for experienced, energetic, creative, and self-reliant professionals for exciting career opportunities!

Benefits and Perks:

We are an organization that recognizes and appreciates hard work! We offer a competitive compensation package commensurate with experience, including salary, bonus, paid time off, medical/dental/vision/life insurance and 401k (with matching!). Most importantly, you will have the opportunity to work directly alongside an extraordinary and dedicated team to grow a critical function within a dynamic, growing company.

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