Claims Analyst I

Citizens

. Review proofs of loss quickly .

Posted 10/15/2026full-timeAustin • Texas • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in claims administration, including reviewing proofs of loss, determining coverage, and processing claims while maintaining compliance with HIPAA regulations. Strong analytical, organizational, and communication skills are essential for effective customer service and collaboration with various stakeholders.

Highest-signal resume keywords

Claims AdministrationAnalytical SkillsCustomer ServiceMicrosoft Office ProficiencyALHC Certification

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ProcessingPolicy ReviewFinancial AnalysisMathematical SkillsClaims Discrepancy Resolution

Soft Skills

Interpersonal SkillsOrganizational SkillsWritten CommunicationVerbal CommunicationRelationship Building

Certifications & Qualifications

Associate, Customer Service (ACS)Associate, Life & Health Claims (ALHC)ALMI Certification

Industry Keywords

Claims ManagementProofs of LossPolicy ProvisionsHIPAA ComplianceFinancial Standards

About the role

Key responsibilities & impact

Review proofs of loss quickly
Administer claims according to policy provisions and company practices and philosophy
Answer inbound telephone inquiries from policy beneficiaries or representatives
Provide excellent service during claims inquiries
Correspond with agents, policyholders, hospitals, doctors, attorneys, beneficiaries, and claimants regarding claims
Resolve customer concerns through outgoing calls or written communications
Maintain communication with management regarding assigned responsibilities
Perform special projects as required or requested
Review policy contracts and determine whether coverage applies
Review and prepare claims for processing and update claims information in the claims application
Determine base payments using policy coverage and limits
Decide whether to pay, investigate further, or deny claims
Assess, research, and correct claims discrepancies with team members
Maintain claims information, follow-ups, pending inventory, verification records, and verification inventory
Maintain complete confidentiality of company business
Cross-train on various product processing within the claims department
Meet established financial, payment, and procedural accuracy standards
Exercise release authority according to experience level, up to specified limits

Requirements

What you’ll need

Bachelor’s degree preferred; insurance-related work experience and strong computer skills acceptable
Courses in business, finance, economics, and mathematics are particularly helpful
Complete LOMA 1 & 2 (280 & 290) courses
Associate, Customer Service (ACS) designation and working toward the Associate, Life & Health Claims designation (ALHC)
ALHC and ALMI certifications are necessary for advancement to a claims manager position
Skill in Microsoft Office products
Excellent analytical, organizational, and interpersonal skills
Well-developed written and verbal communication skills
Strong math and/or financial skills
Comply with HIPAA and other privacy regulations
Ability to establish rapport and build professional relationships
Ability to operate in a fast-paced environment shaped by constant change and innovation
Ability to balance prompt claim settlement with accurate liability determination

Benefits

Comp & perks

Medical insurance
Dental insurance
Vision insurance
Short-term disability
Long-term disability
AD&D insurance
Group term life insurance
Matching 401(k)
Virtual Visits
Employee Assistance Program
Generous Paid Time Off
Paid holidays
Professional growth opportunities
Participation in educational seminars, webinars, and local claims meetings