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.
What is this job like?
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
- Examine claims forms and other records to determine insurance coverage.
- Report overpayments, underpayments, and other irregularities.
- Prepare reports to be submitted to company's data processing department.
- Obtain credit information from banks and other credit services.
- Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
- Pay and process claims within designated authority level.
- Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
- Examine titles to property to determine validity and act as company agent in transactions with property owners.
- Confer with legal counsel on claims requiring litigation.
- Supervise claims adjusters to ensure that adjusters have followed proper methods.
- Investigate and assess damage to property and create or review property damage estimates.
- 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.
- Present cases and participate in their discussion at claim committee meetings.
- Analyze information gathered by investigation and report findings and recommendations.
- Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
- Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
- Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
- 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.
- Conduct detailed bill reviews to implement sound litigation management and expense control.
- Communicate with reinsurance brokers to obtain information necessary for processing claims.
- Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
- Collect evidence to support contested claims in court.
- Refer questionable claims to investigator or claims adjuster for investigation or settlement.
- Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
Local Wage Data
Showing wage data for: New Orleans
Entry
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Hourly Wage
$42,490
$70,840
$99,800
$20.43
$34.06
$47.98