Statewide occupation search

Sort your search results or select and compare details of two occupations. Find out if an occupation is in demand or not in demand in your local area, at Learn about an occupation.

Statewide occupation search

Claims Adjusters, Examiners, and Investigators

It's a bright outlook for

This career will grow rapidly in the next few years.

Learn more about what they do.

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.

Related: Credit Authorizers, Checkers, & Clerks Customer Service Representatives Eligibility Interviewers, Government Programs Insurance Claims & Policy Processing Clerks Tax Examiners & Collectors, & Revenue Agents

Industries: Finance & Insurance Government

Summary
Details

Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
Collect evidence to support contested claims in court.
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
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.
Analyze information gathered by investigation and report findings and recommendations.
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.
Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
Obtain credit information from banks and other credit services.
Confer with legal counsel on claims requiring litigation.
Prepare reports to be submitted to company's data processing department.
Report overpayments, underpayments, and other irregularities.
Supervise claims adjusters to ensure that adjusters have followed proper methods.
Attend mediations or trials.
Conduct detailed bill reviews to implement sound litigation management and expense control.
Pay and process claims within designated authority level.
Resolve complex, severe exposure claims, using high service oriented file handling.
Examine titles to property to determine validity and act as company agent in transactions with property owners.
Examine claims forms and other records to determine insurance coverage.
Analyze information gathered by investigation and report findings and recommendations.
Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
Refer questionable claims to investigator or claims adjuster for investigation or settlement.
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Resolve complex, severe exposure claims, using high service oriented file handling.
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.
Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
Present cases and participate in their discussion at claim committee meetings.
Communicate with reinsurance brokers to obtain information necessary for processing claims.
Investigate and assess damage to property and create or review property damage estimates.
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.
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.

Judgment and Decision Making
- Thinking about the pros and cons of different options and picking the best one.
Systems Analysis
- Figuring out how a system should work and how changes in the future will affect it.
Installation
- Installing equipment, machines, wiring, or computer programs.
Management of Personnel Resources
- Selecting and managing the best workers for a job.
Reading Comprehension
- Reading work-related information.
Speaking
- Talking to others.
Active Listening
- Listening to others, not interrupting, and asking good questions.
Equipment Selection
- Deciding what kind of tools and equipment are needed to do a job.
Science
- Using scientific rules and strategies to solve problems.
Systems Evaluation
- Measuring how well a system is working and how to improve it.
Time Management
- Managing your time and the time of other people.
Technology Design
- Making equipment and technology useful for customers.
Repairing
- Repairing machines or systems using the right tools.
Quality Control Analysis
- Testing how well a product or service works.
Operations Analysis
- Figuring out what a product or service needs to be able to do.
Complex Problem Solving
- Noticing a problem and figuring out the best way to solve it.
Operations Monitoring
- Watching gauges, dials, or display screens to make sure a machine is working.
Operation and Control
- Using equipment or systems.
Management of Financial Resources
- Making spending decisions and keeping track of what is spent.
Critical Thinking
- Thinking about the pros and cons of different ways to solve a problem.
Service Orientation
- Looking for ways to help people.
Active Learning
- Figuring out how to use new ideas or things.
Learning Strategies
- Using the best training or teaching strategies for learning new things.
Management of Material Resources
- Managing equipment and materials.
Writing
- Writing things for co-workers or customers.
Monitoring
- Keeping track of how well people and/or groups are doing in order to make improvements.
Persuasion
- Talking people into changing their minds or their behavior.
Social Perceptiveness
- Understanding people's reactions.
Equipment Maintenance
- Planning and doing the basic maintenance on equipment.
Troubleshooting
- Figuring out what is causing equipment, machines, wiring, or computer programs to not work.
Programming
- Writing computer programs.
Instructing
- Teaching people how to do something.
Coordination
- Changing what is done based on other people's actions.
Negotiation
- Bringing people together to solve differences.
Mathematics
- Using math to solve problems.

Inductive Reasoning
- Making general rules or coming up with answers from lots of detailed information.
Oral Expression
- Communicating by speaking.
Written Expression
- Communicating by writing.
Number Facility
- Adding, subtracting, multiplying, or dividing.
Response Orientation
- Quickly deciding if you should move your hand, foot, or other body part.
Near Vision
- Seeing details up close.
Memorization
- Remembering words, numbers, pictures, or steps.
Category Flexibility
- Grouping things in different ways.
Selective Attention
- Paying attention to something without being distracted.
Flexibility of Closure
- Seeing hidden patterns.
Speech Clarity
- Speaking clearly.
Manual Dexterity
- Holding or moving items with your hands.
Auditory Attention
- Paying attention to one sound while there are other distracting sounds.
Time Sharing
- Doing two or more things at the same time.
Multilimb Coordination
- Using your arms and/or legs together while sitting, standing, or lying down.
Glare Sensitivity
- Seeing something even if there is a glare or very bright light.
Dynamic Strength
- Exercising for a long time without your muscles getting tired.
Hearing Sensitivity
- Telling the difference between sounds.
Mathematical Reasoning
- Choosing the right type of math to solve a problem.
Control Precision
- Quickly changing the controls of a machine, car, truck or boat.
Fluency of Ideas
- Coming up with lots of ideas.
Arm-Hand Steadiness
- Keeping your arm or hand steady.
Speech Recognition
- Recognizing spoken words.
Visualization
- Imagining how something will look after it is moved around or changed.
Gross Body Equilibrium
- Keeping your balance or staying upright.
Peripheral Vision
- Seeing something to your side when your are looking ahead.
Oral Comprehension
- Listening and understanding what people say.
Originality
- Creating new and original ideas.
Deductive Reasoning
- Using rules to solve problems.
Sound Localization
- Noticing the direction that a sound came from.
Speed of Limb Movement
- Quickly moving your arms and legs.
Information Ordering
- Ordering or arranging things.
Rate Control
- Changing when and how fast you move based on how something else is moving.
Trunk Strength
- Using your lower back and stomach.
Finger Dexterity
- Putting together small parts with your fingers.
Reaction Time
- Quickly moving your hand, finger, or foot based on a sound, light, picture or other command.
Static Strength
- Lifting, pushing, pulling, or carrying.
Visual Color Discrimination
- Noticing the difference between colors, including shades and brightness.
Written Comprehension
- Reading and understanding what is written.
Night Vision
- Seeing at night or under low light.
Gross Body Coordination
- Moving your arms, legs, and mid-section together while your whole body is moving.
Depth Perception
- Deciding which thing is closer or farther away from you, or deciding how far away it is from you.
Perceptual Speed
- Quickly comparing groups of letters, numbers, pictures, or other things.
Spatial Orientation
- Knowing where things are around you.
Wrist-Finger Speed
- Making fast, simple, repeated movements of your fingers, hands, and wrists.
Problem Sensitivity
- Noticing when problems happen.
Stamina
- Exercising for a long time without getting out of breath.
Extent Flexibility
- Bending, stretching, twisting, or reaching with your body, arms, and/or legs.
Explosive Strength
- Jumping, sprinting, or throwing something.
Speed of Closure
- Quickly knowing what you are looking at.
Dynamic Flexibility
- Quickly and repeatedly bending, stretching, twisting, or reaching out with your body, arms, and/or legs.
Far Vision
- Seeing details that are far away.

Engineering and Technology
- Knowledge of the practical application of engineering science and technology. This includes applying principles, techniques, procedures, and equipment to the design and production of various goods and services.
Production and Processing
- Knowledge of raw materials, production processes, quality control, costs, and other techniques for maximizing the effective manufacture and distribution of goods.
Biology
- Knowledge of plant and animal organisms, their tissues, cells, functions, interdependencies, and interactions with each other and the environment.
Chemistry
- Knowledge of the chemical composition, structure, and properties of substances and of the chemical processes and transformations that they undergo. This includes uses of chemicals and their interactions, danger signs, production techniques, and disposal methods.
English Language
- Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
Foreign Language
- Knowledge of the structure and content of a foreign (non-English) language including the meaning and spelling of words, rules of composition and grammar, and pronunciation.
Fine Arts
- Knowledge of the theory and techniques required to compose, produce, and perform works of music, dance, visual arts, drama, and sculpture.
History and Archeology
- Knowledge of historical events and their causes, indicators, and effects on civilizations and cultures.
Law and Government
- Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.
Transportation
- Knowledge of principles and methods for moving people or goods by air, rail, sea, or road, including the relative costs and benefits.
Public Safety and Security
- Knowledge of relevant equipment, policies, procedures, and strategies to promote effective local, state, or national security operations for the protection of people, data, property, and institutions.
Sociology and Anthropology
- Knowledge of group behavior and dynamics, societal trends and influences, human migrations, ethnicity, cultures, and their history and origins.
Food Production
- Knowledge of techniques and equipment for planting, growing, and harvesting food products (both plant and animal) for consumption, including storage/handling techniques.
Sales and Marketing
- Knowledge of principles and methods for showing, promoting, and selling products or services. This includes marketing strategy and tactics, product demonstration, sales techniques, and sales control systems.
Administration and Management
- Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
Mathematics
- Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.
Personnel and Human Resources
- Knowledge of principles and procedures for personnel recruitment, selection, training, compensation and benefits, labor relations and negotiation, and personnel information systems.
Design
- Knowledge of design techniques, tools, and principles involved in production of precision technical plans, blueprints, drawings, and models.
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.
Therapy and Counseling
- Knowledge of principles, methods, and procedures for diagnosis, treatment, and rehabilitation of physical and mental dysfunctions, and for career counseling and guidance.
Education and Training
- Knowledge of principles and methods for curriculum and training design, teaching and instruction for individuals and groups, and the measurement of training effects.
Building and Construction
- Knowledge of materials, methods, and the tools involved in the construction or repair of houses, buildings, or other structures such as highways and roads.
Mechanical
- Knowledge of machines and tools, including their designs, uses, repair, and maintenance.
Geography
- Knowledge of principles and methods for describing the features of land, sea, and air masses, including their physical characteristics, locations, interrelationships, and distribution of plant, animal, and human life.
Philosophy and Theology
- Knowledge of different philosophical systems and religions. This includes their basic principles, values, ethics, ways of thinking, customs, practices, and their impact on human culture.
Economics and Accounting
- Knowledge of economic and accounting principles and practices, the financial markets, banking, and the analysis and reporting of financial data.
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.
Psychology
- Knowledge of human behavior and performance; individual differences in ability, personality, and interests; learning and motivation; psychological research methods; and the assessment and treatment of behavioral and affective disorders.
Computers and Electronics
- Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.
Medicine and Dentistry
- Knowledge of the information and techniques needed to diagnose and treat human injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures.
Telecommunications
- Knowledge of transmission, broadcasting, switching, control, and operation of telecommunications systems.
Communications and Media
- Knowledge of media production, communication, and dissemination techniques and methods. This includes alternative ways to inform and entertain via written, oral, and visual media.
Physics
- Knowledge and prediction of physical principles, laws, their interrelationships, and applications to understanding fluid, material, and atmospheric dynamics, and mechanical, electrical, atomic and sub-atomic structures and processes.

Education

High school diploma or equivalent

Work Experience

No work experience

Training

More than 1 year on-the-job training

Education and Training Opportunities

Washington Annual Salary

80100/yr

Washington Hourly Wage

38.51/hr

Currently Employed

6,030

Yearly Projected Openings

410

Conventional: People interested in this work like activities that include data, detail, and regular routines. They do well at jobs that need:

Integrity
Stress Tolerance
Dependability
Attention to Detail
Initiative
Achievement/Effort

Automotive computer systems
Desktop computers
Measuring wheels for distance
Notebook computers
Personal computers
Personal digital assistant PDAs or organizers
Portable data input terminals
Scanners
Tablet computers
Theodolites

Access software
Analytical or scientific software
Computer aided design CAD software
Data base reporting software
Data base user interface and query software
Desktop publishing software
Document management software
Electronic mail software
Enterprise resource planning ERP software
Expert system software
Financial analysis software
Information retrieval or search software
Interactive voice response software
Internet browser software
Medical software
Office suite software
Presentation software
Spreadsheet software
Video conferencing software
Word processing software

ADDITIONAL RESOURCES

Find Claims Adjusters, Examiners, and Investigators jobs Education and Training for Claims Adjusters, Examiners, and Investigators

Statewide occupation search

Statewide occupation search

Claims Adjusters, Examiners, and Investigators

Work Activities

Skills

Abilities

Knowledge

Education

Pay

Washington Employment Trends

Personality

Tools

Technology

ADDITIONAL RESOURCES