Claims Examiners, Property & Casualty Insurance


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.
Also called: Claims Adjuster, Claims Examiner, Claims Representative, Claims Specialist

Knowledge:

    Business
  • customer service
  • management
    Arts and Humanities
  • English language
    Safety and Government
  • law and government

Skills:

    Basic Skills
  • reading work related information
  • writing things for co-workers or customers
    Problem Solving
  • noticing a problem and figuring out the best way to solve it
    Social
  • bringing people together to solve differences
  • understanding people's reactions

Abilites:

    Verbal
  • listen and understand what people say
  • read and understand what is written
    Ideas and Logic
  • use rules to solve problems
  • notice when problems happen

Personality:

Description: People interested in this work like activities that include data, detail, and regular routines.
    They do well at jobs that need
  • Integrity
  • Dependability
  • Attention to Detail
  • Stress Tolerance
  • Self Control
  • Cooperation

Technology:

    Document management software
  • BCCORP W5 for Adjusters
  • Document management system software
    Expert system software
  • Axonwave Fraud and Abuse Management System
  • Bill review software
    Medical software
  • Healthcare common procedure coding system HCPCS
  • Medical condition coding software

Education:

    bachelor's degree
    high school diploma/GED
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