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Title

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Claims Examiner

Description

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We are looking for a meticulous Claims Examiner to analyze and determine the extent of our insurance company's liability. The Claims Examiner will be responsible for investigating, researching, and facilitating claims. You will review and process complex claims, and when necessary, consult with legal counsel. You will be responsible for maintaining fair claim settlements, ensuring legal compliance, and maintaining claim files. The ideal candidate will have a keen eye for detail, be knowledgeable about different types of insurance policies, and have excellent negotiation skills. You should be able to interpret insurance policies and contracts, and be able to work under pressure.

Responsibilities

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  • Investigate, evaluate and settle claims.
  • Maintain claim files and ensure compliance with state regulations.
  • Consult with legal counsel when necessary.
  • Interpret insurance policies and contracts.
  • Negotiate claim settlements.
  • Communicate with claimants, insurance agents, and other parties.
  • Prepare reports on claim settlement details.
  • Review and process complex claims.
  • Ensure fair claim settlements.
  • Work under pressure and meet deadlines.

Requirements

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  • Bachelor's degree in Business Administration or related field.
  • Previous experience in claims examination.
  • Knowledge of insurance policies and contracts.
  • Excellent negotiation skills.
  • Strong analytical skills.
  • Ability to work under pressure.
  • Excellent communication skills.
  • Keen eye for detail.
  • Good organizational skills.
  • Ability to interpret insurance policies and contracts.

Potential interview questions

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  • How do you handle high-pressure situations?
  • Can you describe a time when you had to interpret a complex insurance policy?
  • How do you ensure fair claim settlements?
  • What is your experience with negotiating claim settlements?
  • How do you maintain claim files?