Claims Examiner Career Description

Claims Examiners is a job title generally found within property and casualty insurance companies. It often refers to a more senior position where the examiner reviews the submitted claims and ensures that company guidelines have been followed, as well as acting as an adjuster for more complex or costly insurance claims.

Online colleges offering programs for Claims Examiners

Claims Examiners Career Specializations

Claims examiners might also specialize in group insurance plans or hospital or even dental plans. They will be most often employed by life or health insurance companies in that case. Others might specialize in property damage or insurance claims.

Job Duties and Responsibilities

The majority of claims examiners are employed by life or health insurance companies. In life insurance companies claim examiner might review the cause of death and also in examine new applications for life insurance. Within health insurance companies claims examiners examine costs of health care and determine whether those costs are reasonable.

Work Environment

The majority of claims examiners work standard office hours and a five day work week. Except in cases where a major disaster has occurred and in that case they may be required to assist the claims adjusters on the site.

Employment Outlook and Opportunities

For the most part, claims examiners will be found within the insurance industry employed by life or health insurance firms.

The US Department of Labor projects a 9% job growth from 2006 to 2016. In relationship to other careers this is about average job growth. The widespread use of customer service representatives in call centers to accept the initial claim reduces the number of examiners and adjusters required. Despite streamlining techniques for the claims process this portion of the industry is expected to experience job growth because there are facets to examining claims that simply cannot be automated.

How much does a Claims Examiner make - Claims Examiner Salaries and Wages

Earnings for Claims Examiners with 1 to 4 years experience are reported to be in the range of $34,930-$50,000.

Earnings for Claims Examiners with 5 to 9 years experience are reported at $38,101-$57,000 annually.

Earnings for Claims Examiners with 10 to 19 years experience are reported to be in the range of $41,136 - $61,232 per year.

How to Become a Claims Examiner

Education for Claims Examiners

Educational requirements vary according to the company employing the claims examiner, and the state regulations governing claims examiners. These regulations change from state to state. However, most companies prefer to employ claims examiners with degrees. Due to the increasingly competitive environment companies and generally select the person with the best educational credentials.

Claims Examiners is a title in some companies that signify a senior position. Because federal and state laws and court decisions change how claims should be handled and who can be covered by insurance policies continuing education is extremely important to the claims examiner. However beginning claims examiners can expect to work upon small projects with close supervision. Licensure requirements vary from state to state and some require specialized coursework and others require very little.

Other Qualifications

The claims examiner should be comfortable with Internet research, computer applications, dealing with the public and have an eye to detail. Though the hours for the claims examiner are generally regular office hours and examiner might bear in mind that during emergency situations travel and long hours may be required.

Career Advancement

Advancement opportunities are available for claims examiners to show competence in their work, as well as the go on to earn professional certifications. Most often a number of continuing education credits are required to keep certifications current.

Use the handy links on this site to get detailed information about educational opportunities and coursework for a Claims Examiner career.

claims Examiners Resources

National Association of Independent Insurance Adjusters
American Association of Independent Claims Professionals

Online Colleges Offering Business and Finance Degrees

Accreditation  

University of Phoenix is accredited by the Higher Learning Commission and is a member of the North Central Association. .

AZ Campus Colleges Offering Claims Examiners Programs

Accreditation  

University of Phoenix is accredited by the Higher Learning Commission and is a member of the North Central Association. .

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