All About Property and Casualty Insurance Claims Examiners
Position Description 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.
List of Insurance Claims Examiner Job Duties
- Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
- Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
- Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
- Present cases and participate in their discussion at claim committee meetings.
- Pay and process claims within designated authority level.
- Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
What an Insurance Claims Examiner Should Know
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.
Related Job Titles for this Occupation:
- Property Damage Claims Adjustor
- Workers Compensation Examiner
- Corporate Claims Examiner
- Claims Representative
- Executive Relations Specialist
What Kind of Insurance Claims Examiner Job Opportunities Are There?
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. There will be an estimated 24,500 positions for Insurance Claims Examiner per year.
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.
Do Property and Casualty Insurance Claims Examiners Make A Lot Of Money?
The typical yearly salary for Property and Casualty Insurance Claims Examiners is somewhere between $39,620 and $98,660.
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|
|District of Columbia||$74,210|
What Tools & Technology 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
How to Become an Insurance Claims Examiner
Individuals working as a Property and Casualty Insurance Claims Examiner have obtained the following education levels:
What work experience do I need to become an Insurance Claims Examiner?
Where do Property and Casualty Insurance Claims Examiners Work?
The table below shows some of the most common industries where those employed in this career field work.
Those thinking about becoming a Property and Casualty Insurance Claims Examiner might also be interested in the following careers:
- Social Science Research Assistants
- Loan Counselors
- Cost Estimators
- Title Examiners, Abstractors, and Searchers
- Financial Analysts
Those who work as a Property and Casualty Insurance Claims Examiner sometimes switch careers to one of these choices:
More about our data sources and methodologies.
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