What Do Property and Casualty Insurance Claims Examiner Do?
Insurance Claims Examiner Definition 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.
A Day in the Life of an Insurance Claims Examiner
- Prepare reports to be submitted to company’s data processing department.
- Conduct detailed bill reviews to implement sound litigation management and expense control.
- Supervise claims adjusters to ensure that adjusters have followed proper methods.
- Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
- Report overpayments, underpayments, and other irregularities.
- Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
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What Every Insurance Claims Examiner Should Know
Below is a list of the skills most Property and Casualty Insurance Claims Examiners say are important on the job.
Reading Comprehension: Understanding written sentences and paragraphs in work related documents.
Writing: Communicating effectively in writing as appropriate for the needs of the audience.
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
- Claims Auditor
- Reinsurance Claim Analyst
- Claims Supervisor
- Claims Specialist
- Insurance Examiner
Job Demand 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. 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.
How Much Does an Insurance Claims Examiner Make?
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 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 & Technology 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
- Bill review software
- CCC GuidePost Decision Support
- CSC Fault Evaluator
- Fair Isaac SmartAdvisor
- First Notice Systems ClaimCapture
- Hummingbird Legal Bill Review
- IBM Fraud and Abuse Management System
- ISO ClaimSearch
- ISO NetMap for Claims
How to Become an Insurance Claims Examiner
What kind of Property and Casualty Insurance Claims Examiner requirements are there?
What work experience do I need to become an Insurance Claims Examiner?
Related Careers
Those interested in being a Property and Casualty Insurance Claims Examiner may also be interested in:
- 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
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