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Claims Adjusters and Examiners

  • Finance

Tasks

What tasks do Claims Adjusters and Examiners perform?

  • Examine claims forms and other records to determine insurance coverage.

  • Analyze information gathered by investigation and report findings and recommendations.

  • 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.

  • Pay and process claims within designated authority level.


Knowledge

What do Claims Adjusters and Examiners need to know?

  • Customer and Personal Service

    Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.

  • English Language

    Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.

  • Administrative

    Knowledge of administrative and office procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and workplace terminology.


Skills

What skills do Claims Adjusters and Examiners need?

  • 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.

  • Critical Thinking

    Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.



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Data on career profiles are based on information supplied by the O*NET Program, sponsored by U.S. Department of Labor, Employment, and Training Administration.