ZipRecruiter

Log In

1

Claim File Reviewer Jobs (NOW HIRING)

RLI Corp.

Claim Investigation Specialist I

Peoria, IL · On-site

Define vendor deliverables, timelines, budgets, and follow-up expectations, review vendor work product for completeness, accuracy, and usefulness to the claim file. * Assist with litigation and pre ...

RLI Corp.

Claim Investigation Specialist I

Peoria, IL · On-site

Define vendor deliverables, timelines, budgets, and follow-up expectations, review vendor work product for completeness, accuracy, and usefulness to the claim file. * Assist with litigation and pre ...

AIG

Global Quality Assurance Reviewer

Atlanta, GA · On-site

The primary responsibility is to perform claim file reviews to evaluate Best Practices compliance and claim handling improvement opportunities, throughout the life of a claim file, across AIG Claims.

AIG

Global Quality Assurance Reviewer

Lenexa, KS

The primary responsibility is to perform claim file reviews to evaluate Best Practices compliance and claim handling improvement opportunities, throughout the life of a claim file, across AIG Claims.

Berkley

Claims Correspondence Analyst

Marlborough, MA · On-site

$50K - $60K/yr

Review and prescreen information received for initial claim file setups * Maintain accurate records of all interactions and updates in the claims system and/or shared drive * Ensure compliance and ...

next page

Showing results 1-20

All JobsClaim File Reviewer Jobs

Claim File Reviewer information

See salary details

$13

$21

$28

How much do claim file reviewer jobs pay per hour?

As of Jul 21, 2026, the average hourly pay for claim file reviewer in the United States is $21.05, according to ZipRecruiter salary data. Most workers in this role earn between $18.03 and $22.84 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Claim File Reviewer, and why are they important?

To thrive as a Claim File Reviewer, you need strong attention to detail, analytical skills, and a solid understanding of insurance policies or claims processing, typically backed by relevant experience or a degree in a related field. Familiarity with claims management software, document management systems, and sometimes industry certifications like AIC (Associate in Claims) are commonly required. Excellent organizational skills, discretion, and effective communication are valuable soft skills for accuracy and collaboration. These capabilities ensure thorough and compliant claim reviews, minimizing errors and supporting fair outcomes for all parties.

What are some common challenges Claim File Reviewers face when evaluating complex insurance claims?

Claim File Reviewers often encounter complex cases that require careful analysis of policy details, medical records, and legal documentation. A key challenge is balancing efficiency with thoroughness, as missing critical information can lead to incorrect claim decisions. Additionally, reviewers must navigate tight deadlines while collaborating closely with adjusters, legal teams, and sometimes customers to resolve discrepancies. Staying updated on changing regulations and company policies is also essential to ensure accurate and compliant reviews.

What is the difference between Claim File Reviewer vs Claims Adjuster?

AspectClaim File ReviewerClaims Adjuster
Required CredentialsHigh school diploma or equivalent; some roles may require insurance certificationsHigh school diploma; insurance licenses or certifications often preferred
Work EnvironmentOffice setting, reviewing claim files and documentationOffice or field, investigating claims and interacting with claimants
Industry UsageInsurance companies, third-party administratorsInsurance companies, independent adjusting firms
Search & Comparison IntentUnderstanding role differences, job requirements, and career pathsComparing responsibilities, credentials, and work scope

The Claim File Reviewer primarily focuses on reviewing and verifying claim documentation within an office environment, often requiring minimal certifications. In contrast, Claims Adjusters investigate claims, sometimes in the field, and may hold insurance licenses. Both roles are integral to the insurance industry but differ in scope, responsibilities, and required credentials.

What are Claim File Reviewers?

Claim File Reviewers are professionals who evaluate insurance claims to ensure their accuracy, completeness, and compliance with policy guidelines. They review submitted documents, assess the validity of claims, and may request additional information or clarification from claimants. Their work helps insurance companies detect errors, prevent fraud, and make fair decisions regarding claim approvals or denials. Claim File Reviewers play a crucial role in maintaining the integrity of the claims process and upholding industry standards.
More about Claim File Reviewer jobs
What states have the most Claim File Reviewer jobs? States with the most job openings for Claim File Reviewer jobs include:
What job categories do people searching Claim File Reviewer jobs look for? The top searched job categories for Claim File Reviewer jobs are:
Claim File Reviewer jobs near you
Infographic showing various Claim File Reviewer job openings in the United States as of July 2026, with employment types broken down into 79% Full Time, 19% Part Time, 1% Temporary, and 1% Contract. Highlights an 87% Physical, 4% Hybrid, and 9% Remote job distribution, with an average salary of $43,783 per year, or $21 per hour.
Claim Investigation Specialist I

Claim Investigation Specialist I

RLI Corp.

Peoria, IL • On-site

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 7 days ago

Job description

About Us
We're not like other insurance companies. From our specialty products to our business model, our culture to our results - we're different. Different is who we are, and how we work, interact, deliver and succeed together. Creating a different and better insurance experience doesn't just happen. It takes focus and a shared passion for going beyond the expected to forge relationships and deliver care that makes a difference. This approach rises from and is supported by our talented, ethical and smart team of employee owners united around a single purpose: to work alongside our customers and partners when they need us, in unexpected ways, with exceptional results. Apply today to make a difference with us.
RLI is a Glassdoor Best Places to Work company with a strong, successful background. For decades, our financial track record has been stellar - a testament to our culture and validation of our reputation as an excellent underwriting company.
Position Overview
This is an exciting opportunity to join RLI's Claims organization in a specialized investigative role. The Claim Investigation Specialist will assist claim examiners and managers with the timely development of facts, evidence, damages information, public-record research, vendor assignments, and claim documentation.
We are looking for a proactive, detail-oriented professional who can thrive in a fast-paced claim environment, manage multiple priorities, and play a critical role in supporting the investigation, evaluation, and resolution of claims. This role is well suited for someone with claim handling, legal, paralegal, investigative, or liability experience who is interested in developing deeper claim expertise while helping improve claim outcomes across the organization.
The position will partner closely with claim examiners, claim managers, defense counsel, vendors, and other internal stakeholders to ensure claims are investigated thoroughly, efficiently, and consistently.
Principal Duties & Responsibilities
  • Perform rapid fact development on assigned claims, including obtaining and analyzing police reports, fire reports, incident reports, accident response letters, 911 audio, dash-camera or body-camera materials, scene photographs, surveillance materials, and other relevant evidence.
  • Identify, request, preserve, and track key third-party evidence, including video footage, electronic data, event data recorder information, photographs, witness information, repair records, employment records, business records, and public records.
  • Conduct targeted public-record, docket, DMV, property, licensing, corporate, and other database research to assist with liability, damages, recovery, and exposure analysis.
  • Perform open-source and social media research to corroborate liability facts, claimed injuries, damages, activities, employment status, business operations, or other relevant claim issues; document search methodology and preserve findings appropriately.
  • Assist with medical and damages development by requesting authorizations, ordering medical records and bills, organizing records, preparing medical chronologies, summarizing specials, and identifying prior injuries, causation issues, apportionment issues, treatment gaps, liens, or other damages-related concerns.
  • Support claim examiners by preparing concise factual summaries, damages summaries, investigation timelines, witness summaries, and issue lists that identify completed work, outstanding needs, and recommended next steps.
  • Monitor and document the progress of investigations handled by claimants, insureds, vendors, defense counsel, underlying carriers, or other involved parties, as applicable.
  • Identify investigative gaps, delays, inconsistencies, or divergence from claim-handling best practices and escalate issues to the assigned claim examiner or manager.
  • Scope, assign, and manage vendors, including field investigators, scene inspectors, nurse reviewers, medical record review vendors, accident reconstructionist, engineers, cause-and-origin experts, and other claim-support resources.
  • Define vendor deliverables, timelines, budgets, and follow-up expectations, review vendor work product for completeness, accuracy, and usefulness to the claim file.
  • Assist with litigation and pre-litigation file development by organizing key facts, evidence, records, timelines, and claim materials for claim examiners, managers, and defense counsel.
  • Support claim quality by ensuring investigative activities, evidence requests, vendor assignments, and summaries are documented clearly and timely in the claim file.
  • Communicate professionally with insureds, claimants, counsel, vendors, internal business partners, and other parties as appropriate.
  • Perform other claim investigation, file development, and claim support duties as assigned.

Education & Experience
  • Bachelor's degree preferred.
  • 2+ years of claim handling, liability investigation, paralegal, legal assistant, insurance investigation, or related experience preferred but not required.
  • Experience with auto liability, general liability, professional liability, property, casualty, litigation, or complex claim environments preferred.
  • Experience obtaining and analyzing records, reports, public records, medical records, billing records, court filings, or investigative materials preferred.
  • Experience working with vendors, experts, defense counsel, or outside investigators is a plus.
  • Experience with umbrella, bodily injury, or litigated claims is a plus.

Knowledge, Skills & Competencies
  • Proactive approach to investigation, claim development, and problem solving.
  • Strong analytical and investigative skills.
  • Ability to identify relevant facts, missing information, inconsistencies, and claim exposure issues.
  • Strong written and verbal communication skills.
  • Strong organization, time management, and follow-up skills.
  • Ability to manage multiple priorities in a fast-paced claim environment.

Compensation Overview
The base salary range for the position is listed below. Please note that the base salary is only one component of our robust total rewards package at RLI. The salary offered will take into account a number of factors including, but not limited to, geographic location, experience, scope & responsibilities of the role, qualifications/credentials, talent availability & specialization, as well as business needs. The below range may be modified in the future.
Base Pay Range
$23.05 - $32.33
Total Rewards
At RLI, we're all owners. We hire the best and the brightest employees and allow them to share in the company's success through our Total Rewards. With the Employee Stock Ownership plan at its core, the Total Rewards program includes all compensation, benefits and perks that come with being an RLI employee.
Financial Incentives
  • Annual bonus plans
  • Employee stock ownership plan (ESOP)
  • 401(k) - automatic 3% company contribution
  • Annual 401k and ESOP profit-sharing contributions (Up to 15% of eligible earnings)

Work & Life
  • Paid time off (PTO) and holidays
  • Paid volunteer time off (VTO) to support our communities
  • Parental and family care leave
  • Flexible & hybrid work arrangements
  • Fitness center discounts and free virtual fitness platform
  • Employee assistance program

Health & Wellness
  • Comprehensive medical, dental and vision benefits
  • Flexible spending and health savings accounts
  • 2x base salary for group life and AD&D insurance
  • Voluntary life, critical illness, & accident insurance for purchase
  • Short-term and long-term disability benefits

Personal & Professional Growth
RLI encourages its employees to pursue professional development work in insurance and job-related areas. We make a commitment to employees to provide educational opportunities that help them enhance their skills and further their career advancement. RLI fosters a true learning culture and encourages professional growth through insurance courses, in-house training and other educational programs. RLI covers the cost for most programs and employees typically earn a bonus upon successful completion of approved courses and certifications. Our personal and professional growth benefits include:
  • Training & certification opportunities
  • Tuition reimbursement
  • Education bonuses

Diversity & Inclusion
Our goal is to attract, develop and retain the best employee talent from diverse backgrounds while promoting an environment where all viewpoints are valued and individuals feel respected, are treated fairly, and have an opportunity to excel in their chosen careers. We actively support, and participate in, initiatives led by the American Property Casualty Insurance Association that aim to increase diversity in the insurance industry. Cultivating an exceptional and diverse workforce to deliver excellent customer service reinforces our culture and is a key to achieving superior business results.
RLI is an equal opportunity employer and does not discriminate in hiring or employment on the basis of race, color, religion, national origin, citizenship, gender, marital status, sexual orientation, age, disability, veteran status, or any other characteristic protected by federal, state, or local law.
RLI logo

About RLI

Sourced by ZipRecruiter

Industry

Insurance services

Company size

1,001 - 5,000 Employees

Headquarters location

Peoria, IL, US

Year founded

1965

View All RLI Jobs

Apply