Claims Examiner Duties & Responsibilities
The role and function of a Claims Examiner includes the following duties and responsibilities:
- Diligently review reports to ensure that no errors have been made in the appraisal process.
- Determine whether payouts are reasonable.
- Approve, reject or refer a claim to a specialist.
- Meet with claimants and settle disputes.
- Ensure compliance with regulatory standards, company policy and guidelines.
- Provide assistance to Claims Adjusters to manage the volume of cases.
- Consult with specialists such as lawyers, engineers, architects and physicians.
- Assist attorneys and other specialists when defending the company against contestation.
Note that this is not an exhaustive list of Claims Examiner duties and responsibilities. Job functions for specific Claims Examiner roles may vary, depending on the industry and type of employer.