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Property and Casualty Insurance Claims Examiner

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What Do Property and Casualty Insurance Claims Examiner Do?

Example of Insurance Claims Examiner Job Review settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures. Report overpayments, underpayments, and other irregularities. Confer with legal counsel on claims requiring litigation.

Daily Life Of an Insurance Claims Examiner

  • Confer with legal counsel on claims requiring litigation.
  • Report overpayments, underpayments, and other irregularities.
  • Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
  • Supervise claims adjusters to ensure that adjusters have followed proper methods.
  • Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
  • Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.

Skills Needed to be an Insurance Claims Examiner

These are the skills Property and Casualty Insurance Claims Examiners say are the most useful in their careers:

Writing: Communicating effectively in writing as appropriate for the needs of the audience.

Reading Comprehension: Understanding written sentences and paragraphs in work related documents.

Active Listening: Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.

Speaking: Talking to others to convey information effectively.

Critical Thinking: Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.

Negotiation: Bringing others together and trying to reconcile differences.

  • Liability Claims Representative
  • Claims Account Specialist
  • Workers Compensation Claims Examiner
  • Claims Supervisor
  • Claims Account Manager

Is There Job Demand for Property and Casualty Insurance Claims Examiners?

There were about 311,100 jobs for Property and Casualty Insurance Claims Examiner in 2016 (in the United States). There is little to no growth in job opportunities for Property and Casualty Insurance Claims Examiner. The BLS estimates 24,500 yearly job openings in this field.

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The states with the most job growth for Insurance Claims Examiner are Utah, Arizona, and Colorado. Watch out if you plan on working in Maine, District of Columbia, or Mississippi. These states have the worst job growth for this type of profession.

Insurance Claims Examiner Salary

The average yearly salary of an Insurance Claims Examiner ranges between $39,620 and $98,660.

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Property and Casualty Insurance Claims Examiners who work in Connecticut, Massachusetts, or New Jersey, make the highest salaries.

How much do Property and Casualty Insurance Claims Examiners make in different U.S. states?

State Annual Mean Salary
Alabama $65,060
Alaska $73,370
Arizona $67,340
Arkansas $61,930
California $71,720
Colorado $72,460
Connecticut $78,590
Delaware $63,440
District of Columbia $74,210
Florida $62,840
Georgia $65,430
Hawaii $62,860
Idaho $63,020
Illinois $65,980
Indiana $63,480
Iowa $62,750
Kansas $67,570
Kentucky $55,820
Louisiana $66,440
Maine $60,980
Maryland $72,050
Massachusetts $76,150
Michigan $67,860
Minnesota $65,760
Mississippi $62,700
Missouri $66,340
Montana $55,970
Nebraska $61,050
Nevada $65,510
New Hampshire $71,190
New Jersey $74,260
New Mexico $63,890
New York $71,950
North Carolina $62,580
North Dakota $58,580
Ohio $65,890
Oklahoma $61,670
Oregon $67,750
Pennsylvania $67,730
Rhode Island $71,950
South Carolina $62,950
South Dakota $61,490
Tennessee $60,550
Texas $69,560
Utah $59,330
Vermont $66,240
Virginia $63,640
Washington $72,340
West Virginia $57,030
Wisconsin $63,420
Wyoming $65,300

What Tools do Property and Casualty Insurance Claims Examiners Use?

Below is a list of the types of tools and technologies that Property and Casualty Insurance Claims Examiners may use on a daily basis:

  • Microsoft Excel
  • Microsoft Word
  • Microsoft Office
  • Microsoft PowerPoint
  • Microsoft Publisher
  • Medical procedure coding software
  • Healthcare common procedure coding system HCPCS
  • Medical condition coding software
  • Document management system software
  • Hyland OnBase Enterprise Content Management
  • Axonwave Fraud and Abuse Management System
  • StrataCare StrataWare eReview
  • LexisNexis RiskWise
  • CCC Pathways Appraisal Quality Solution
  • ISO NetMap for Claims
  • ISO ClaimSearch
  • IBM Fraud and Abuse Management System
  • Hummingbird Legal Bill Review
  • Agency Management Systems AMS 360
  • AutoClaims Direct DirectLink

Becoming an Insurance Claims Examiner

Individuals working as a Property and Casualty Insurance Claims Examiner have obtained the following education levels:

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What work experience do I need to become an Insurance Claims Examiner?

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Who Employs Property and Casualty Insurance Claims Examiners?

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The table below shows some of the most common industries where those employed in this career field work.

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You May Also Be Interested In…

Those thinking about becoming a Property and Casualty Insurance Claims Examiner might also be interested in the following careers:

Those who work as a Property and Casualty Insurance Claims Examiner sometimes switch careers to one of these choices:

References:

Image Credit: Nick Youngson via Creative Commons 3 - CC BY-SA 3.0

More about our data sources and methodologies.

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