What You Need to Know About Property and Casualty Insurance Claims Examiner
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.
List of Insurance Claims Examiner Job Duties
- Conduct detailed bill reviews to implement sound litigation management and expense control.
- 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.
- Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
- Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
- Pay and process claims within designated authority level.
- Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
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What Skills Do You Need to Work as an Insurance Claims Examiner?
When polled, Property and Casualty Insurance Claims Examiners say the following skills are most frequently used in their jobs:
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
- Corporate Claims Examiner
- Home Office Claim Specialist
- Claims Auditor
- Executive Relations Specialist
- Customer Care Specialist
Are There Job Opportunities 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. The BLS estimates 24,500 yearly job openings in this field.
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.
What is the Average Salary of an Insurance Claims Examiner
Property and Casualty Insurance Claims Examiners make between $39,620 and $98,660 a year.
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 |
Tools & Technologies Used by Property and Casualty Insurance Claims Examiners
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
Becoming an Insurance Claims Examiner
Learn what Property and Casualty Insurance Claims Examiner education requirements there are.
How Long Does it Take to Become an Insurance Claims Examiner?
Property and Casualty Insurance Claims Examiners Sector
Property and Casualty Insurance Claims Examiners work in the following industries:
Other Jobs You May be Interested In
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:
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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