Insurance Claims Adjuster Job Description, Duties, and Responsibilities

This post provides detailed information on the insurance claims adjuster job description, including the key duties, tasks, and responsibilities they commonly perform.

It also highlights the major requirements that you may be asked to meet to be hired for the insurance claims adjuster role by most employers/recruiters.

What Does an Insurance Claims Adjuster Do?

An insurance claims adjuster is responsible for investigating insurance claims of clients to find out the extent of liability of the insurance company and how much to be paid for settlement that would be fair to both sides.

Claims adjusters work on various claims, ranging from property claims involving damage to buildings, structures, and vehicles; liability claims involving personal injuries; and claims on third-person property damage.

The insurance claims adjuster job description entails reviewing cases separately by having a conversation with the claimant.

He/she carries out research on records, including medical and police records; perform inspection on the property involved; and interview any witness.

The claim adjuster’s role also involves following a set of general claim and statutory guidelines in assessing and investigating policy coverage, damages, and liability as quickly as possible.

He/she provides a high level of customer service while attending to both internal and external customers, answering their questions about claims on phone or by written correspondence.

He/she identifies all potential exposures and creates initial reserves and when necessary make adjustments throughout the claim.

The insurance claims adjuster work description also involves applying a lowest ultimate cost strategy in investigating and evaluating claims.

It also entails following company guidelines in creating and maintaining relevant diary of open claims.

The claims adjuster is expected to conduct thorough investigation on a claim by taking various steps, including obtaining the necessary forms and documents from the claimant and insured, and performing recorded statements.

He/she is also expected to complete all appraisers in a timely manner and to identify damages involving accidents.

When necessary, the claim adjuster will negotiate with insureds, claimants, and attorneys on timely and appropriate settlements, and then release payments based on the agreements reached.

His/her duties include opening and processing correspondence on assigned claims and spotting recovery opportunities concerning salvage and subrogation.

Insurance Claims Adjuster Job Description Example/Sample/Template

Insurance claims adjusters perform various functions in ensuring quick investigation and processing of claims, reach settlement and make payments to claimants.

The job description below highlights major insurance claims adjuster duties, tasks, and responsibilities:

• Contact claimants for relevant information concerning their claims and accurately evaluate and process claims under the insurance policy coverage
• Impute data collected from claimant into processing system online
• Carry out evaluation of claim submission to determine if the claimant is eligible or not by applying a variety of methods and by comparing to the benefits of the policy
• Finalize claims as quickly as possible by completing research and/or requesting further information from providers, policyholders, and other parties relevant to the claim
• Responsible for managing pending files and creating correspondence relating to claims
• Relate with both policyholders and agents and answer whatever questions they may have through various means, including email, web, and phone
• Responsible for managing ongoing waiver of premium claims
• Work closely and effectively with other members of the team to ensure customers’ needs, work flow, and follow up are resolved speedily
• Achieve the Department’s quality and time service standards.

Requirements – Skills, Abilities, and Knowledge – for Insurance Claims Adjuster Role

When hiring for the position of insurance claims adjuster, employers usually look out for certain skills, knowledge, abilities, educational qualification, etc. in applicants that they believe will enable them to give top performance on the job.

Provided below are typical employers’ requirements that applicants for the role of claims adjuster must possess to be qualified for an interview:

• Strong ability to work with system applications to quickly find required information and respond to customers’ needs
• Possess a Business Bachelor’s Degree or other related degree from accredited four year college
• Strong ability to understand, speak, and write in English and another language such as Spanish
• Quality and customer service focused
• Exceptional organizational skills and strong ability to give attention to detail
• Strong ability to perform multiple tasks in a fast-paced environment
• Excellent decision making and analytical skills
• Ability to work with MS Office, including Word, Outlook, and Excel efficiently and effectively
• Strong keyword skills – above 30 wpm
• Deep knowledge of Windows based Personal Computer.

Conclusion

If you are an employer in the process of hiring for the position of insurance claims adjuster and you need a good job description to attract the desired candidates, the content of this post can help you create one.

The sample job description and information about the claim adjuster’s duties, responsibilities, and requirements presented in this article can be used in making a description for the role that perfectly captures the functions and requirements of the position in your company.

If you are an individual interested in getting into the insurance career as a claims adjuster, this post will also be helpful to you in improving your knowledge about the role.