Claim Adjuster/Examiner/Investigators are an extremely important piece to the many businesses where citizens make claims to receive financial compensation or other benefits. Without a claims investigator in an insurance company, people could just make false claims and receive money fraudulently. They could do the same for disability even if they are not disabled. The primary function of this job is deciding the legitimacy of claims, so they financially protect the business that they work for.
Most of the job for Claim Adjuster/Examiner/Investigators takes place in an office, but many find themselves outside of the office frequently. For example, if an insurance customer makes a claim on damage to their house, the claim investigator must go to their house to inspect the damage, the cause of it, and possible amount of compensation. The job does not involve much physical work other than some travel to where claims are made. The job primarily makes use of regular office supplies, pen and paper, a telephone, and computer. A Bachelor's degree is usually required to work in this field. However, some may be hired with equivalent experience. Workers in this field often work with others of the same title, they have a supervisor, and they work with customers or those who are making a claim to try and receive compensation or benefits. They tend not to have subordinates unless they are a supervising claims adjuster with a team of claim adjusters.
Work hours for this job are typically Monday through Friday, 9 AM to 5 PM or 8 AM to 4 PM. Claim Adjusters/Examiners/Investigators work regular office hours as is the norm for people who might be calling them to make a claim. A typical day may be spent in the office on the phone and doing paperwork. It may also be all day out in the field visiting businesses or the residence of those who have made claims. It may also be a mixture of both.
The position of Claim Adjuster/Examiner/Investigator is vital to any business that people may be seeking some sort of compensation from. Without this position, the finances of the business would fluctuate, be insecure, and have many taking advantage of it, receiving money when they do not deserve it. Without a person in this position, these companies would lose money.
Claims Adjuster / Examiner / Investigator Tasks
Perform detailed investigations, field audits, and telephone interviews to research claims.
Follow and maintain claims management guidelines.
Provide updates on customer problems and safety or policy violations.
Maintain documentation of claim and claim denial, and report on pending claims and findings to the Claims Manager.