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Property and Casualty Insurance Claims Examiner

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All About Property and Casualty Insurance Claims Examiners

Job 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.

Insurance Claims Examiner Responsibilities

  • Confer with legal counsel on claims requiring litigation.
  • Resolve complex, severe exposure claims, using high service oriented file handling.
  • Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
  • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
  • Pay and process claims within designated authority level.
  • Present cases and participate in their discussion at claim committee meetings.

What an Insurance Claims Examiner Should Know

Property and Casualty Insurance Claims Examiners state the following job skills are important in their day-to-day work.

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.

Other Insurance Claims Examiner Job Titles

  • Claims Manager
  • Claims Supervisor
  • Claims Analyst
  • Reinsurance Claim Analyst
  • Worker’s Compensation Claims Examiner

Job Outlook for Property and Casualty Insurance Claims Examiners

In 2016, there was an estimated number of 311,100 jobs in the United States for Property and Casualty Insurance Claims Examiner. There is little to no growth in job opportunities for Property and Casualty Insurance Claims Examiner. Due to new job openings and attrition, there will be an average of 24,500 job openings in this field each year.

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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 Average 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 each U.S. state?

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?

Although they’re not necessarily needed for all jobs, the following technologies are used by many Property and Casualty Insurance Claims Examiners:

  • 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 do I Become an Insurance Claims Examiner?

Education needed to be a Property and Casualty Insurance Claims Examiner:

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How many years of work experience do I need?

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Where Property and Casualty Insurance Claims Examiners Work

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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 interested in being a Property and Casualty Insurance Claims Examiner may also be interested in:

Career changers with experience as a Property and Casualty Insurance Claims Examiner sometimes find work in one of the following fields:

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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