Claims Adjusters, Examiners, and Investigators

Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confer with legal counsel on claims requiring litigation. May also settle insurance claims.

68 alternate job titles:

Accident Investigator Adjuster Adjustment Clerk Benefit Authorizer Bodily Injury Claims Adjuster Bodily Injury Claims Examiner Claims Account Specialist Claims Adjuster Claims Adjustor Claims Agent Claims Analyst Claims Approver Claims Auditor Claims Consultant Claims Examiner Claims Inspector Claims Investigator Claims Processor Claims Representative Claims Service Adjustor Claims Service Specialist Claims Specialist Clerical Adjuster Commercial Insurance Inspector Compensation Adjuster Corporate Claims Examiner Disability Analyst Disability Examiner Disability Specialist Field Claims Adjuster Field Investigator Field Liability Generalist Field Property Claims Adjuster Field Property Claims Specialist Fire Adjuster Fire Claims Adjuster General Adjuster Health Claims Examiner Health Insurance Adjuster Home Office Claims Examiner Home Office Claims Specialist Independent Insurance Adjuster Insurance Adjuster Insurance Appraiser Insurance Auditor Insurance Claims Adjuster Insurance Examiner Insurance Fraud Investigator Insurance Inspector Investigator Liability Claims Examiner Liability Claims Representative Litigation Claims Representative Litigation Examiner Medical Claims Analyst Medical Claims Examiner Medical Claims Specialist Property Adjuster Property and Casualty Insurance Claims Examiner Property Claims Adjuster Property Damage Claims Adjustor Reinsurance Claims Analyst Residential Insurance Inspector Salvage Determiner Workers' Compensation Claims Adjuster Workers' Compensation Claims Examiner Workers' Compensation Claims Representative Workers' Compensation Examiner
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Salary Information

Claims Adjusters, Examiners, and Investigators: $76,790 (median) per year.

Starting salary (10th percentile).
Required expreience: Varies by Company


Data source: U.S. Bureau of Labor Statistics

Daily Tasks & Responsibilities

Task Description Category
Calculate data to inform organizational operations. General
Investigate legal issues. General
Prepare legal or investigatory documentation. General
Estimate costs of goods or services. General
Appraise property values. General
Interview witnesses, suspects, or claimants. General
Negotiate agreements to resolve disputes. General
Implement financial decisions. General
Advise others on financial matters. General
Apply information technology to solve business or other applied problems. General
Resolve customer complaints or problems. General
Pay charges, fees, or taxes. General
Verify accuracy of records. General
Collect evidence for legal proceedings. General
Prepare financial documents. General
Examine financial records. General
Confer with others about financial matters. General
Prepare operational reports. General
Gather financial records. General
Verify application data to determine program eligibility. General
Advise others on legal or regulatory compliance matters. General
Maintain data in information systems or databases. Maintenance
Report information to managers or other personnel. Management
Supervise employees. Management
Meet with individuals involved in legal processes to provide information and clarify issues. Communication
Present business-related information to audiences. Communication
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    Technology Requirements

    Technology Description
    Microsoft Excel Spreadsheet software
    Microsoft Office software Office suite software
    Microsoft Outlook Electronic mail software
    Apple Safari Internet browser software
    Microsoft PowerPoint Presentation software
    Microsoft Word Word processing software
    Mozilla Firefox Internet browser software
    Zoom Video conferencing software
    4n6xprt Systems StiffCalcs Computer aided design CAD software
    ADP software Enterprise resource planning ERP software
    ARSoftware WinSMAC Computer aided design CAD software
    Agency Management Systems AMS 360 Document management software
    AutoClaims Direct DirectLink Document management software
    Automatic Data Processing Autosource Document management software
    Automatic Data Processing Claims Manager & Dispatch Document management software
    Automatic Data Processing Estimating Financial analysis software
    Axonwave Fraud and Abuse Management System Expert system software
    BCCORP Burkitt W5 Document management software
    BCCORP W5 for Adjusters Document management software
    Bill review software Expert system software
    Bramerhill ClaimsTech Document management software
    Bridium Claims 3 Document management software
    Brightwork Alyce Claims Systems Document management software
    Business software applications Office suite software
    CAD Zone Insurance Computer aided design CAD software
    CCC EZNet electronic communications network Access software
    CCC GuidePost Decision Support Expert system software
    CCC Pathways Appraisal Quality Solution Enterprise resource planning ERP software
    CCC Pathways Image Management Solution Document management software
    CCC TL2000 Solution Document management software
    CGI INSideOUT Document management software
    CGI-AMS BureauLink Enterprise Information retrieval or search software
    CSC Automated Work Distributor AWD Access software
    CSC Colossus Financial analysis software
    CSC Fault Evaluator Expert system software
    Captiva InputAccel Document management software
    Castek Insure3 Claims Document management software
    Clear Technology Tranzax Document management software
    Computerized voice stress analyzer CVSA software Interactive voice response software
    Covansys ClaimConnect Document management software
    Datanex ClaimTrac Document management software
    Document management system software Document management software
    Fair Isaac SmartAdvisor Expert system software
    First Notice Systems ClaimCapture Expert system software
    Healthcare common procedure coding system HCPCS Medical software
    Hummingbird Legal Bill Review Expert system software
    Hyland OnBase Enterprise Content Management Document management software
    IBM Fraud and Abuse Management System Expert system software
    ISO ClaimSearch Expert system software
    ISO NetMap for Claims Expert system software
    InSystems Calligo Document Management System Document management software
    Injury Sciences EDR InSight Analytical or scientific software
    Insurance claims fraud detection software Analytical or scientific software
    LexisNexis RiskWise Expert system software
    Magnify Predictive Targeting System Analytical or scientific software
    MapScenes Evidence Recorder Computer aided design CAD software
    MapScenes Pro Computer aided design CAD software
    Medical condition coding software Medical software
    Medical procedure coding software Medical software
    Microsoft Publisher Desktop publishing software
    PhotoModeler Computer aided design CAD software
    Property damage, bodily injury, and liability estimation software Financial analysis software
    QwikQuote software Financial analysis software
    Simsol for Adjusters Financial analysis software
    StrataCare StrataWare eReview Expert system software
    Turtle Creek Software Goldenseal Architect Financial analysis software
    Visual Statement Investigator Suite Computer aided design CAD software
    Microsoft Access Data base user interface and query software
    Xactware Xactimate Data base user interface and query software
    Claims processing administration and management software Data base user interface and query software
    Corporate Systems ClaimsPro Data base reporting software
    Fair Isaac Claims Advisor Data base user interface and query software
    Tropics Claims Reserve Management Data base user interface and query software
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      Relevant Certifications

      Industry certifications that may be valuable for this career role:

      Certification Issuing Organization Practice Test
      Accredited Financial Examiner - Financial Analyst Society of Financial Examiners Not Available
      Accredited Insurance Examiner Insurance Regulatory Examiners Society Not Available
      Accredited Marine Surveyor Society of Accredited Marine Surveyors Not Available
      Associate Insurance Data Manager Insurance Data Management Association Not Available
      Associate in Claims The Institutes Not Available
      Associate in Claims - Management The Institutes Not Available
      Associate in National Flood Insurance The Institutes Not Available
      Associate in Regulation and Compliance The Institutes Not Available
      Associate in Reinsurance The Institutes Not Available
      Associate, Life and Health Claims International Claim Association Not Available
      Associate, Reinsurance Administration LOMA Not Available
      Automated Examination Specialists Society of Financial Examiners Not Available
      Certified Financial Examiner Society of Financial Examiners Not Available
      Certified Forensic Claims Consultant AACE International, Inc. Not Available
      Certified Fraud Examiner Association of Certified Fraud Examiners Not Available
      Certified Insurance Data Manager Insurance Data Management Association Not Available
      Certified Insurance Examiner Insurance Regulatory Examiners Society Not Available
      Certified Insurance Fraud Investigator International Association of Special Investigation Units Not Available
      Fellow, Life and Health Claims International Claim Association Not Available
      Senior Professional Public Adjuster The Institutes Not Available
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