Claims Examiners, Property and Casualty Insurance

Course Advisor; Maine; On-site; USD 39,000 - 99,000; Full time

Job summary

An established industry player is seeking a detail-oriented Property and Casualty Insurance Claims Examiner to join their team. In this pivotal role, you will review and evaluate insurance claims, ensuring compliance with company policies while investigating discrepancies. Your critical thinking and negotiation skills will be essential as you work closely with legal counsel on complex claims. This position offers an opportunity to make a significant impact in the insurance field, contributing to fair and prompt claim resolutions. If you are passionate about delivering quality service and possess strong analytical abilities, this role is perfect for you.

Qualifications

• Strong writing and critical thinking skills are essential.
• A Bachelor's degree is typically required for this role.

Responsibilities

• Review and evaluate insurance claims for accuracy and compliance.
• Investigate claims and supervise adjusters to ensure proper methods are followed.

Skills

Writing

Reading Comprehension

Active Listening

Speaking

Critical Thinking

Negotiation

Education

Bachelor's Degree

Relevant Certification

Tools

Microsoft Excel

Microsoft Word

Document Management System Software

Hyland OnBase Enterprise Content Management

Job description

Property and Casualty Insurance Claims Examiner

What Do Property and Casualty Insurance Claims Examiners 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.

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

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

The states with the most job growth for Insurance Claims Examiners 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.

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

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
• 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:

Who Employs Property and Casualty Insurance Claims Examiners?

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