How To Become A Claims Service Specialist: What It Is and Career Path

What is a claims service specialist and how to become one

Updated January 8, 2025

4 min read

Claims service specialists, sometimes called only claims specialists, work for insurance companies and process insurance claims. They are in charge of reviewing client cases in order to determine the coverage that they deserve. Claims service specialists conduct investigations by interviewing clients and sometimes even traveling in person to assess damage. Claims service specialists need excellent attention to detail in order to process claims accurately and input billing codes. They also need to be highly knowledgeable about company policies and government regulations, which change frequently. Claims service specialists can't neglect soft skills such as communication which help them build strong relationships with clients.

A claims service specialist is an entry-level position within the insurance industry. However, someone with some customer service experience, for example working as a cashier, may find it easier to get a job. They earn an entry-level salary of $36,170 a year.

Less than half of claims service specialists have a bachelor's degree. A claims service specialist with a diploma may find it easier to move up the corporate ladder.

ScoreClaims Service SpecialistUS Average

Salary

3.1

Avg. Salary $39,962

Avg. Salary $59,228

Stability level

5.9

Growth rate -4%

Growth rate 0.3%

Diversity

9.2

Race

American Indian and Alaska Native 0.70%

Asian 6.04%

Black or African American 10.43%

Hispanic or Latino 21.02%

Unknown 5.27%

White 56.54%

Gender

female 73.32%

male 26.68%

Age - 39

Race

American Indian and Alaska Native 3.00%

Asian 7.00%

Black or African American 14.00%

Hispanic or Latino 19.00%

White 57.00%

Gender

female 47.00%

male 53.00%

Age - 39

Stress level

5.9

Stress level is manageable

7.1 - high

Complexity level

6.6

Complexity level is challenging

7 - challenging

Work life balance

6.5

Work life balance is good

6.4 - fair

Key steps to become a claims service specialist

Explore claims service specialist education requirements

Most common claims service specialist degrees

Bachelor's

47.9 %

Associate

20.5 %

High School Diploma

20.2 %

Start to develop specific claims service specialist skills

Skills	Percentages
Customer Service	12.26%
Process Claims	8.99%
Data Entry	7.39%
Auto Claims	5.83%
Telephone Calls	5.26%

Complete relevant claims service specialist training and internships

Accountants spend an average of 6-12 months on post-employment, on-the-job training. New claims service specialists learn the skills and techniques required for their job and employer during this time. The chart below shows how long it takes to gain competency as a claims service specialist based on U.S. Bureau of Labor Statistics data and data from real claims service specialist resumes.

Research claims service specialist duties and responsibilities

Manage expedition of appeals via problem solving and collaboration with other departments.
Perform data entry and assessment evaluations regarding admitting patients in facilities.
Verify demographics, review EOB's, bill charges and modifiers.
Answer all correspondence pertaining patient, provider or policy per HIPAA guidelines.

Prepare your claims service specialist resume

When your background is strong enough, you can start writing your claims service specialist resume.

You can use Zippia's AI resume builder to make the resume writing process easier while also making sure that you include key information that hiring managers expect to see on a claims service specialist resume. You'll find resume tips and examples of skills, responsibilities, and summaries, all provided by Zippi, your career sidekick.

Choose from 10+ customizable claims service specialist resume templates

Build a professional claims service specialist resume in minutes. Browse through our resume examples to identify the best way to word your resume. Then choose from 10+ resume templates to create your claims service specialist resume.