What does a Claims Adjusters, Examiners, and Investigator do?

Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Day to day that includes work like examine claims forms and other records to determine insurance coverage and Analyze information gathered by investigation and report findings and recommendations.

What skills should a Claims Adjusters, Examiners, and Investigator put on a resume?

O*NET rates Reading Comprehension, Active Listening, Critical Thinking, Speaking, and Judgment and Decision Making among the most important skills for this occupation. Name the ones that are genuinely yours and show where you used them. A resume that lists skills you do not have is weaker than one that lists fewer.

What software should a Claims Adjusters, Examiners, and Investigator list?

Software recorded for this occupation includes 4n6xprt Systems StiffCalcs, ADP software, Agency Management Systems AMS 360, Apple Safari, and ARSoftware WinSMAC. Applicant tracking systems match on the exact product name, so write the tool as the posting writes it rather than describing it in general terms.

What other job titles cover Claims Adjusters, Examiners, and Investigator work?

O*NET records 40 titles for this occupation, including Claims Adjuster, Claims Analyst, Claims Examiner, and Claims Representative. Searching only your own job title hides most of the openings you could apply to.

What qualifications does a Claims Adjusters, Examiners, and Investigator need?

In O*NET's survey of people doing this job, 56% reported their level of education as "Bachelor's Degree". That is what current postholders reported, not a requirement any single employer sets.

Will this resume pass an ATS for a Claims Adjusters, Examiners, and Investigator role?

No tool outside an employer can tell you how that employer's system is configured, including ours. What you can control is that the resume parses cleanly, names the work in the words the posting uses, and does not claim anything you cannot back up.

Claims Adjusters, Examiners, and Investigator resume example

A resume for a Claims Adjusters, Examiners, and Investigator needs to show the work itself: review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Day to day that means work like this: examine claims forms and other records to determine insurance coverage; analyze information gathered by investigation and report findings and recommendations. Recruiters and applicant tracking systems both read for the tasks and tools this role actually involves, so the strongest resume names them in your own experience rather than describing the job in the abstract. Below are the tasks O*NET records for this occupation, the software and tools it uses, the titles it is advertised under, and the skills worth naming if they are genuinely yours.

Also advertised as

The same job is posted under many titles. Searching only your own job title hides most of the openings you could apply to.

Claims Adjuster
Claims Analyst
Claims Examiner
Claims Representative
Claims Specialist
Corporate Claims Examiner
Field Claims Adjuster
General Adjuster
Home Office Claims Specialist
Litigation Claims Representative
Accident Investigator
Adjuster
Adjustment Clerk
Benefit Authorizer
Bodily Injury Claims Adjuster
Claims Account Specialist
Claims Adjustor
Claims Agent

O*NET records 40 titles for this occupation in total.

What this work actually involves

Tasks recorded for this occupation, in O*NET's words. If your experience covers one of these, it belongs on your resume in your own words.

Examine claims forms and other records to determine insurance coverage.
Analyze information gathered by investigation and report findings and recommendations.
Pay and process claims within designated authority level.
Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
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.
Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
Investigate and assess damage to property and create or review property damage estimates.
Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Resolve complex, severe exposure claims, using high service oriented file handling.
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.

29 tasks are recorded in total; these are the most central.

Example bullets for this role

Built from this occupation's own tasks. The brackets stay empty on purpose: we will not invent a number for you, and a fabricated metric is the fastest way to lose an interview you had already won.

Examine claims forms and other records to determine insurance coverage, for [who or what it served], at [what volume].
Analyze information gathered by investigation and report findings and recommendations, for [who or what it served], at [what volume].
Pay and process claims within designated authority level, for [who or what it served], at [what volume].
Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio, for [who or what it served], at [what volume].

Software used in this role

Recorded for this occupation by O*NET. An applicant tracking system matches the exact product name, so write the tool the way the posting writes it.

4n6xprt Systems StiffCalcs
ADP software
Agency Management Systems AMS 360
Apple Safari
ARSoftware WinSMAC
AutoClaims Direct DirectLink
Automatic Data Processing Autosource
Automatic Data Processing Claims Manager & Dispatch
Automatic Data Processing Estimating
Axonwave Fraud and Abuse Management System
BCCORP Burkitt W5
BCCORP W5 for Adjusters
Bill review software
Bramerhill ClaimsTech

73 software entries are recorded in total.

Tools and equipment

The physical equipment this occupation is recorded as using. Worth naming when a posting asks for it by name.

Data collectors
Desktop computers
Event data recorders
Field computers
Handheld computers
Measure markers
Mobile wireless handheld communication devices
Notebook computers
Personal computers
Personal digital assistants PDA
Scanners
Tablet computers

Skills an ATS reads for

Worth naming only if they are genuinely yours. Keyword overlap is one input to a resume's score, not a verdict.

Xactware Xactimate
Zoom
4n6xprt Systems StiffCalcs
ADP
Agency Management Systems AMS 360
Apple Safari

What this job rates as most important

O*NET rates every skill for importance to this occupation. These are the highest rated, in order.

01Reading Comprehension
02Active Listening
03Critical Thinking
04Speaking
05Judgment and Decision Making
06Writing
07Complex Problem Solving
08Monitoring
09Social Perceptiveness
10Active Learning

Knowledge areas

The subject knowledge this occupation draws on, rated by importance.

Customer and Personal Service
English Language
Administrative
Mathematics
Computers and Electronics
Law and Government
Administration and Management
Economics and Accounting

What qualifications people in this job have

From O*NET's survey of people doing this work. This is what postholders reported, not a requirement any single employer sets.

56%Bachelor's Degree
13%High School Diploma, or the equivalent
12%Associate's Degree

What level this role is pitched at

O*NET places this occupation in “Considerable Preparation Needed”. Most of these occupations require a four-year bachelor's degree, but some do not.

A considerable amount of work-related skill, knowledge, or experience is needed for these occupations. For example, an accountant must complete four years of college and work for several years in accounting to be considered qualified.

Common questions

What does a Claims Adjusters, Examiners, and Investigator do?: Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Day to day that includes work like examine claims forms and other records to determine insurance coverage and Analyze information gathered by investigation and report findings and recommendations.
What skills should a Claims Adjusters, Examiners, and Investigator put on a resume?: O*NET rates Reading Comprehension, Active Listening, Critical Thinking, Speaking, and Judgment and Decision Making among the most important skills for this occupation. Name the ones that are genuinely yours and show where you used them. A resume that lists skills you do not have is weaker than one that lists fewer.
What software should a Claims Adjusters, Examiners, and Investigator list?: Software recorded for this occupation includes 4n6xprt Systems StiffCalcs, ADP software, Agency Management Systems AMS 360, Apple Safari, and ARSoftware WinSMAC. Applicant tracking systems match on the exact product name, so write the tool as the posting writes it rather than describing it in general terms.
What other job titles cover Claims Adjusters, Examiners, and Investigator work?: O*NET records 40 titles for this occupation, including Claims Adjuster, Claims Analyst, Claims Examiner, and Claims Representative. Searching only your own job title hides most of the openings you could apply to.
What qualifications does a Claims Adjusters, Examiners, and Investigator need?: In O*NET's survey of people doing this job, 56% reported their level of education as "Bachelor's Degree". That is what current postholders reported, not a requirement any single employer sets.
Will this resume pass an ATS for a Claims Adjusters, Examiners, and Investigator role?: No tool outside an employer can tell you how that employer's system is configured, including ours. What you can control is that the resume parses cleanly, names the work in the words the posting uses, and does not claim anything you cannot back up.

Related roles

Occupations O*NET records as closest to this one, and worth looking at if this search is not moving.

What this page cannot tell you

No tool outside an employer can tell you how that employer’s ATS is configured, including ours.
This page makes no claim about pay, demand or how many people hold this job. O*NET does not publish that here and we will not estimate it.
Keyword overlap is one input to a resume’s score, not a verdict on you. A resume that names skills you do not have is worse than one that names fewer.

If this is the job you are aiming at, the guide to tailoring a resume covers how to aim one posting properly, and building and exporting a resume here is free.

Occupation data from the O*NET 29.1 Database by the U.S. Department of Labor, Employment and Training Administration (USDOL/ETA), used under CC BY 4.0. O*NET is a trademark of USDOL/ETA. SpartanResume is not endorsed by USDOL/ETA.