State Licensed Claims Examiner

Job Summary

A company is looking for a Claim Examiner responsible for reviewing and processing insurance claims for accuracy and compliance.

Key Responsibilities

• Review and evaluate insurance claims to determine coverage, validity, and eligibility
• Analyze policy coverage and exclusions, and calculate claim payments based on various factors
• Document case facts, negotiate settlements, and identify potential fraudulent claims

Required Qualifications

• 2-10+ years of experience in Insurance Claims Adjusting/Examining preferred
• Bachelor's degree preferred in Business Administration, Legal, Finance, or related field
• State-specific Adjusting/Appraising/Examining/Investigating Licenses required
• Preferred certifications include Associate in Claims (AIC) and Certified Insurance Service Representative (CISR)
• Knowledge of industry trends and insurance laws is beneficial