Claims Examiners, Property and Casualty Insurance

• Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
• Resolve complex, severe exposure claims, using high service oriented file handling.
• Pay and process claims within designated authority level.
• Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
• 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.
• Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
• Confer with legal counsel on claims requiring litigation.
• Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
• Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
• Present cases and participate in their discussion at claim committee meetings.

Source: O*NET OnLine information for Claims Examiners, Property and Casualty Insurance.

• 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.
• Speaking - Talking to others to convey information effectively.
• Critical Thinking - Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
• Negotiation - Bringing others together and trying to reconcile differences.
• Judgment and Decision Making - Considering the relative costs and benefits of potential actions to choose the most appropriate one.
• Social Perceptiveness - Being aware of others' reactions and understanding why they react as they do.
• Complex Problem Solving - Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.
• Monitoring - Monitoring/Assessing performance of yourself, other individuals, or organizations to make improvements or take corrective action.

Source: O*NET OnLine information for Claims Examiners, Property and Casualty Insurance.