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Summary Report for:
13-1031.00 - 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.

The occupation code you requested, 13-1031.01 (Claims Examiners, Property and Casualty Insurance), is no longer in use. In the future, please use 13-1031.00 (Claims Adjusters, Examiners, and Investigators) instead.

Sample of reported job titles: Claim Representative, Claims Adjuster, Claims Analyst, Claims Examiner, Claims Representative, Claims Specialist, Corporate Claims Examiner, General Adjuster, Home Office Claim Specialist, Litigation Claim Representative

View report: Summary  Details  Custom

Tasks  |  Technology Skills  |  Tools Used  |  Knowledge  |  Skills  |  Abilities  |  Work Activities  |  Detailed Work Activities  |  Work Context  |  Job Zone  |  Credentials  |  Interests  |  Work Styles  |  Work Values  |  Related Occupations  |  Wages & Employment  |  Job Openings  |  Additional Information

Tasks

  • Examine claims forms and other records to determine insurance coverage. See more occupations related to this task.
  • Analyze information gathered by investigation and report findings and recommendations. See more occupations related to this task.
  • Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability. See more occupations related to this task.
  • Investigate and assess damage to property and create or review property damage estimates. See more occupations related to this task.
  • Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims. See more occupations related to this task.
  • Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review. See more occupations related to this task.
  • 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. See more occupations related to this task.
  • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies. See more occupations related to this task.
  • Resolve complex, severe exposure claims, using high service oriented file handling. See more occupations related to this task.
  • Pay and process claims within designated authority level. See more occupations related to this task.
  • Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments. See more occupations related to this task.
  • 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. See more occupations related to this task.
  • Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation. See more occupations related to this task.
  • Refer questionable claims to investigator or claims adjuster for investigation or settlement. See more occupations related to this task.
  • Collect evidence to support contested claims in court. See more occupations related to this task.
  • Confer with legal counsel on claims requiring litigation. See more occupations related to this task.
  • Contact or interview claimants, doctors, medical specialists, or employers to get additional information. See more occupations related to this task.
  • Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis. See more occupations related to this task.
  • Present cases and participate in their discussion at claim committee meetings. See more occupations related to this task.
  • Supervise claims adjusters to ensure that adjusters have followed proper methods. See more occupations related to this task.
  • Conduct detailed bill reviews to implement sound litigation management and expense control. See more occupations related to this task.
  • Examine titles to property to determine validity and act as company agent in transactions with property owners. See more occupations related to this task.
  • Report overpayments, underpayments, and other irregularities. See more occupations related to this task.
  • Communicate with reinsurance brokers to obtain information necessary for processing claims. See more occupations related to this task.
  • Prepare reports to be submitted to company's data processing department. See more occupations related to this task.
  • Attend mediations or trials. See more occupations related to this task.
  • Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit. See more occupations related to this task.
  • Negotiate claim settlements or recommend litigation when settlement cannot be negotiated. See more occupations related to this task.

Find occupations related to multiple tasks

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Technology Skills

  • Access software — CCC EZNet electronic communications network; CSC Automated Work Distributor AWD See more occupations related to this technology.
  • Analytical or scientific software — Injury Sciences EDR InSight; Insurance claims fraud detection software; Magnify Predictive Targeting System See more occupations related to this technology.
  • Computer aided design CAD software Hot technology — 4n6xprt Systems StiffCalcs; ARSoftware WinSMAC; PhotoModeler; Visual Statement Investigator Suite (see all 7 examples) See more occupations related to this technology.
  • Data base reporting software — Corporate Systems ClaimsPro See more occupations related to this technology.
  • Data base user interface and query software — Claims processing administration and management software; Fair Isaac Claims Advisor; Tropics Claims Reserve Management See more occupations related to this technology.
  • Desktop publishing software — Microsoft Publisher See more occupations related to this technology.
  • Document management software — Datanex ClaimTrac; Document management system software; Hyland OnBase Enterprise Content Management; InSystems Calligo Document Management System (see all 20 examples) See more occupations related to this technology.
  • Enterprise resource planning ERP software Hot technology — ADP software; CCC Pathways Appraisal Quality Solution See more occupations related to this technology.
  • Expert system software — Axonwave Fraud and Abuse Management System; Bill review software; LexisNexis RiskWise; StrataCare StrataWare eReview (see all 12 examples) See more occupations related to this technology.
  • Financial analysis software — Automatic Data Processing Estimating; CSC Colossus; Simsol for Adjusters; Turtle Creek Software Goldenseal Architect (see all 6 examples) See more occupations related to this technology.
  • Information retrieval or search software — CGI-AMS BureauLink Enterprise See more occupations related to this technology.
  • Interactive voice response software — Computerized voice stress analyzer CVSA software See more occupations related to this technology.
  • Medical software — Healthcare common procedure coding system HCPCS Hot technology ; Medical condition coding software Hot technology ; Medical procedure coding software See more occupations related to this technology.
  • Office suite software — Microsoft Office Hot technology See more occupations related to this technology.
  • Presentation software — Microsoft PowerPoint Hot technology See more occupations related to this technology.
  • Spreadsheet software — Microsoft Excel Hot technology See more occupations related to this technology.
  • Word processing software — Microsoft Word Hot technology See more occupations related to this technology.

Hot technology Hot Technology — a technology requirement frequently included in employer job postings.

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Tools Used

  • Automotive computer systems — Event data recorders See more occupations related to this tool.
  • Desktop computers See more occupations related to this tool.
  • Measuring wheels for distance — Measure markers See more occupations related to this tool.
  • Notebook computers See more occupations related to this tool.
  • Personal computers See more occupations related to this tool.
  • Personal digital assistant PDAs or organizers — Personal digital assistants PDA See more occupations related to this tool.
  • Portable data input terminals — Data collectors; Field computers; Handheld computers; Mobile wireless handheld communication devices See more occupations related to this tool.
  • Scanners See more occupations related to this tool.
  • Tablet computers See more occupations related to this tool.
  • Theodolites — Total stations See more occupations related to this tool.

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Knowledge

  • 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. See more occupations related to this knowledge.
  • English Language — Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar. See more occupations related to this knowledge.
  • Law and Government — Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process. See more occupations related to this knowledge.
  • Clerical — Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology. See more occupations related to this knowledge.
  • Mathematics — Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications. See more occupations related to this knowledge.
  • 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. See more occupations related to this knowledge.

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Skills

  • Critical Thinking — Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems. See more occupations related to this skill.
  • Reading Comprehension — Understanding written sentences and paragraphs in work related documents. See more occupations related to this skill.
  • 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. See more occupations related to this skill.
  • Speaking — Talking to others to convey information effectively. See more occupations related to this skill.
  • Negotiation — Bringing others together and trying to reconcile differences. See more occupations related to this skill.
  • Writing — Communicating effectively in writing as appropriate for the needs of the audience. See more occupations related to this skill.
  • Active Learning — Understanding the implications of new information for both current and future problem-solving and decision-making. See more occupations related to this skill.
  • Judgment and Decision Making — Considering the relative costs and benefits of potential actions to choose the most appropriate one. See more occupations related to this skill.
  • Complex Problem Solving — Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions. See more occupations related to this skill.
  • Social Perceptiveness — Being aware of others' reactions and understanding why they react as they do. See more occupations related to this skill.
  • Monitoring — Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action. See more occupations related to this skill.
  • Service Orientation — Actively looking for ways to help people. See more occupations related to this skill.
  • Coordination — Adjusting actions in relation to others' actions. See more occupations related to this skill.
  • Persuasion — Persuading others to change their minds or behavior. See more occupations related to this skill.
  • Time Management — Managing one's own time and the time of others. See more occupations related to this skill.

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Abilities

  • Oral Comprehension — The ability to listen to and understand information and ideas presented through spoken words and sentences. See more occupations related to this ability.
  • Written Comprehension — The ability to read and understand information and ideas presented in writing. See more occupations related to this ability.
  • Deductive Reasoning — The ability to apply general rules to specific problems to produce answers that make sense. See more occupations related to this ability.
  • Oral Expression — The ability to communicate information and ideas in speaking so others will understand. See more occupations related to this ability.
  • Inductive Reasoning — The ability to combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events). See more occupations related to this ability.
  • Speech Clarity — The ability to speak clearly so others can understand you. See more occupations related to this ability.
  • Near Vision — The ability to see details at close range (within a few feet of the observer). See more occupations related to this ability.
  • Problem Sensitivity — The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem. See more occupations related to this ability.
  • Speech Recognition — The ability to identify and understand the speech of another person. See more occupations related to this ability.
  • Written Expression — The ability to communicate information and ideas in writing so others will understand. See more occupations related to this ability.
  • Information Ordering — The ability to arrange things or actions in a certain order or pattern according to a specific rule or set of rules (e.g., patterns of numbers, letters, words, pictures, mathematical operations). See more occupations related to this ability.
  • Category Flexibility — The ability to generate or use different sets of rules for combining or grouping things in different ways. See more occupations related to this ability.
  • Mathematical Reasoning — The ability to choose the right mathematical methods or formulas to solve a problem. See more occupations related to this ability.
  • Number Facility — The ability to add, subtract, multiply, or divide quickly and correctly. See more occupations related to this ability.

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Work Activities

  • Interacting With Computers — Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information. See more occupations related to this activity.
  • Getting Information — Observing, receiving, and otherwise obtaining information from all relevant sources. See more occupations related to this activity.
  • Making Decisions and Solving Problems — Analyzing information and evaluating results to choose the best solution and solve problems. See more occupations related to this activity.
  • Communicating with Supervisors, Peers, or Subordinates — Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person. See more occupations related to this activity.
  • Resolving Conflicts and Negotiating with Others — Handling complaints, settling disputes, and resolving grievances and conflicts, or otherwise negotiating with others. See more occupations related to this activity.
  • Identifying Objects, Actions, and Events — Identifying information by categorizing, estimating, recognizing differences or similarities, and detecting changes in circumstances or events. See more occupations related to this activity.
  • Documenting/Recording Information — Entering, transcribing, recording, storing, or maintaining information in written or electronic/magnetic form. See more occupations related to this activity.
  • Processing Information — Compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data. See more occupations related to this activity.
  • Evaluating Information to Determine Compliance with Standards — Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards. See more occupations related to this activity.
  • Communicating with Persons Outside Organization — Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources. This information can be exchanged in person, in writing, or by telephone or e-mail. See more occupations related to this activity.
  • Organizing, Planning, and Prioritizing Work — Developing specific goals and plans to prioritize, organize, and accomplish your work. See more occupations related to this activity.
  • Analyzing Data or Information — Identifying the underlying principles, reasons, or facts of information by breaking down information or data into separate parts. See more occupations related to this activity.
  • Updating and Using Relevant Knowledge — Keeping up-to-date technically and applying new knowledge to your job. See more occupations related to this activity.
  • Establishing and Maintaining Interpersonal Relationships — Developing constructive and cooperative working relationships with others, and maintaining them over time. See more occupations related to this activity.
  • Interpreting the Meaning of Information for Others — Translating or explaining what information means and how it can be used. See more occupations related to this activity.
  • Monitor Processes, Materials, or Surroundings — Monitoring and reviewing information from materials, events, or the environment, to detect or assess problems. See more occupations related to this activity.
  • Judging the Qualities of Things, Services, or People — Assessing the value, importance, or quality of things or people. See more occupations related to this activity.
  • Performing for or Working Directly with the Public — Performing for people or dealing directly with the public. This includes serving customers in restaurants and stores, and receiving clients or guests. See more occupations related to this activity.
  • Performing Administrative Activities — Performing day-to-day administrative tasks such as maintaining information files and processing paperwork. See more occupations related to this activity.
  • Thinking Creatively — Developing, designing, or creating new applications, ideas, relationships, systems, or products, including artistic contributions. See more occupations related to this activity.
  • Estimating the Quantifiable Characteristics of Products, Events, or Information — Estimating sizes, distances, and quantities; or determining time, costs, resources, or materials needed to perform a work activity. See more occupations related to this activity.

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Detailed Work Activities

  • Calculate data to inform organizational operations. See more occupations related to this activity.
  • Investigate legal issues. See more occupations related to this activity.
  • Prepare legal or investigatory documentation. See more occupations related to this activity.
  • Estimate costs of goods or services. See more occupations related to this activity.
  • Interview witnesses, suspects, or claimants. See more occupations related to this activity.
  • Appraise property values. See more occupations related to this activity.
  • Negotiate agreements to resolve disputes. See more occupations related to this activity.
  • Supervise employees. See more occupations related to this activity.
  • Advise others on financial matters. See more occupations related to this activity.
  • Implement financial decisions. See more occupations related to this activity.
  • Pay charges, fees, or taxes. See more occupations related to this activity.
  • Verify accuracy of records. See more occupations related to this activity.
  • Maintain data in information systems or databases. See more occupations related to this activity.
  • Report information to managers or other personnel. See more occupations related to this activity.
  • Collect evidence for legal proceedings. See more occupations related to this activity.
  • Meet with individuals involved in legal processes to provide information and clarify issues. See more occupations related to this activity.
  • Examine financial records. See more occupations related to this activity.
  • Prepare financial documents. See more occupations related to this activity.
  • Present business-related information to audiences. See more occupations related to this activity.
  • Confer with others about financial matters. See more occupations related to this activity.
  • Prepare operational reports. See more occupations related to this activity.
  • Gather financial records. See more occupations related to this activity.
  • Advise others on legal or regulatory compliance matters. See more occupations related to this activity.
  • Verify application data to determine program eligibility. See more occupations related to this activity.

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Work Context

  • Electronic Mail — How often do you use electronic mail in this job? See more occupations related to this work context.
  • Telephone — How often do you have telephone conversations in this job? See more occupations related to this work context.
  • Letters and Memos — How often does the job require written letters and memos? See more occupations related to this work context.
  • Frequency of Decision Making — How frequently is the worker required to make decisions that affect other people, the financial resources, and/or the image and reputation of the organization? See more occupations related to this work context.
  • Contact With Others — How much does this job require the worker to be in contact with others (face-to-face, by telephone, or otherwise) in order to perform it? See more occupations related to this work context.
  • Importance of Being Exact or Accurate — How important is being very exact or highly accurate in performing this job? See more occupations related to this work context.
  • Impact of Decisions on Co-workers or Company Results — What results do your decisions usually have on other people or the image or reputation or financial resources of your employer? See more occupations related to this work context.
  • Spend Time Sitting — How much does this job require sitting? See more occupations related to this work context.
  • Deal With External Customers — How important is it to work with external customers or the public in this job? See more occupations related to this work context.
  • Freedom to Make Decisions — How much decision making freedom, without supervision, does the job offer? See more occupations related to this work context.
  • Indoors, Environmentally Controlled — How often does this job require working indoors in environmentally controlled conditions? See more occupations related to this work context.
  • Face-to-Face Discussions — How often do you have to have face-to-face discussions with individuals or teams in this job? See more occupations related to this work context.
  • Importance of Repeating Same Tasks — How important is repeating the same physical activities (e.g., key entry) or mental activities (e.g., checking entries in a ledger) over and over, without stopping, to performing this job? See more occupations related to this work context.
  • Time Pressure — How often does this job require the worker to meet strict deadlines? See more occupations related to this work context.
  • Frequency of Conflict Situations — How often are there conflict situations the employee has to face in this job? See more occupations related to this work context.
  • Structured versus Unstructured Work — To what extent is this job structured for the worker, rather than allowing the worker to determine tasks, priorities, and goals? See more occupations related to this work context.
  • Work With Work Group or Team — How important is it to work with others in a group or team in this job? See more occupations related to this work context.
  • Deal With Unpleasant or Angry People — How frequently does the worker have to deal with unpleasant, angry, or discourteous individuals as part of the job requirements? See more occupations related to this work context.
  • Spend Time Making Repetitive Motions — How much does this job require making repetitive motions? See more occupations related to this work context.
  • Degree of Automation — How automated is the job? See more occupations related to this work context.
  • Level of Competition — To what extent does this job require the worker to compete or to be aware of competitive pressures? See more occupations related to this work context.
  • Coordinate or Lead Others — How important is it to coordinate or lead others in accomplishing work activities in this job? See more occupations related to this work context.
  • Sounds, Noise Levels Are Distracting or Uncomfortable — How often does this job require working exposed to sounds and noise levels that are distracting or uncomfortable? See more occupations related to this work context.
  • Physical Proximity — To what extent does this job require the worker to perform job tasks in close physical proximity to other people? See more occupations related to this work context.

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Job Zone

Title Job Zone Four: Considerable Preparation Needed
Education Most of these occupations require a four-year bachelor's degree, but some do not.
Related Experience A considerable amount of work-related skill, knowledge, or experience is needed for these occupations. For example, an accountant must complete four years of college and work for several years in accounting to be considered qualified.
Job Training Employees in these occupations usually need several years of work-related experience, on-the-job training, and/or vocational training.
Job Zone Examples Many of these occupations involve coordinating, supervising, managing, or training others. Examples include real estate brokers, sales managers, database administrators, graphic designers, chemists, art directors, and cost estimators.
SVP Range (7.0 to < 8.0)

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Credentials

Find Training Find Certifications Find Licenses Apprenticeship.gov

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Interests

Interest code: CEI   Want to discover your interests? Take the O*NET Interest Profiler at My Next Move.

  • Conventional — Conventional occupations frequently involve following set procedures and routines. These occupations can include working with data and details more than with ideas. Usually there is a clear line of authority to follow. See more occupations related to this interest.
  • Enterprising — Enterprising occupations frequently involve starting up and carrying out projects. These occupations can involve leading people and making many decisions. Sometimes they require risk taking and often deal with business. See more occupations related to this interest.
  • Investigative — Investigative occupations frequently involve working with ideas, and require an extensive amount of thinking. These occupations can involve searching for facts and figuring out problems mentally. See more occupations related to this interest.

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Work Styles

  • Integrity — Job requires being honest and ethical. See more occupations related to this work style.
  • Dependability — Job requires being reliable, responsible, and dependable, and fulfilling obligations. See more occupations related to this work style.
  • Attention to Detail — Job requires being careful about detail and thorough in completing work tasks. See more occupations related to this work style.
  • Stress Tolerance — Job requires accepting criticism and dealing calmly and effectively with high stress situations. See more occupations related to this work style.
  • Self Control — Job requires maintaining composure, keeping emotions in check, controlling anger, and avoiding aggressive behavior, even in very difficult situations. See more occupations related to this work style.
  • Independence — Job requires developing one's own ways of doing things, guiding oneself with little or no supervision, and depending on oneself to get things done. See more occupations related to this work style.
  • Adaptability/Flexibility — Job requires being open to change (positive or negative) and to considerable variety in the workplace. See more occupations related to this work style.
  • Initiative — Job requires a willingness to take on responsibilities and challenges. See more occupations related to this work style.
  • Persistence — Job requires persistence in the face of obstacles. See more occupations related to this work style.
  • Achievement/Effort — Job requires establishing and maintaining personally challenging achievement goals and exerting effort toward mastering tasks. See more occupations related to this work style.
  • Analytical Thinking — Job requires analyzing information and using logic to address work-related issues and problems. See more occupations related to this work style.
  • Cooperation — Job requires being pleasant with others on the job and displaying a good-natured, cooperative attitude. See more occupations related to this work style.
  • Concern for Others — Job requires being sensitive to others' needs and feelings and being understanding and helpful on the job. See more occupations related to this work style.
  • Leadership — Job requires a willingness to lead, take charge, and offer opinions and direction. See more occupations related to this work style.
  • Innovation — Job requires creativity and alternative thinking to develop new ideas for and answers to work-related problems. See more occupations related to this work style.
  • Social Orientation — Job requires preferring to work with others rather than alone, and being personally connected with others on the job. See more occupations related to this work style.

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Work Values

  • Support — Occupations that satisfy this work value offer supportive management that stands behind employees. Corresponding needs are Company Policies, Supervision: Human Relations and Supervision: Technical. See more occupations related to this work value.
  • Independence — Occupations that satisfy this work value allow employees to work on their own and make decisions. Corresponding needs are Creativity, Responsibility and Autonomy. See more occupations related to this work value.
  • Working Conditions — Occupations that satisfy this work value offer job security and good working conditions. Corresponding needs are Activity, Compensation, Independence, Security, Variety and Working Conditions. See more occupations related to this work value.

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Wages & Employment Trends

Median wages (2019) $32.11 hourly, $66,790 annual
State wages
Local wages
 
Employment (2019) 332,900 employees
Projected growth (2019-2029) Decline (-1% or lower) Decline (-1% or lower)
Projected job openings (2019-2029) 21,000
State trends
 
Top industries (2019)

Source: Bureau of Labor Statistics 2019 wage data external site and 2019-2029 employment projections external site. "Projected growth" represents the estimated change in total employment over the projections period (2019-2029). "Projected job openings" represent openings due to growth and replacement.

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Job Openings on the Web

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