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Insurance Claims Examiner Jobs (NOW HIRING)

MSI Baldwin

Senior Claims Examiner - MSI

As a leading MGA, MSI combines deep underwriting expertise with insurer risk capacity to create ... The Sr Claims Examiner is considered an expert in managing insurance claims for our policyholders ...

Diedre Moire Corp.

Claims Examiner MedMal

Shorewood, IL · On-site

$100K - $140K/yr

Medical Malpractice Liability Claims Examiner - Joliet, IL Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare _ . REMOTE - WORK FROM ...

Diedre Moire Corp.

Claims Examiner MedMal

Pawtucket, RI · On-site

$100K - $140K/yr

Medical Malpractice Liability Claims Examiner - Pawtucket, RI Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare _ . REMOTE - WORK FROM ...

Next Step Systems

Claims Examiner

Tucson, AZ · On-site

Monitor copays, deductibles, insurance verification, and authorizations. Analyze incoming and ... Claims Examiner Responsibilities: - Submit claims and encounters in a timely manner. - Review and ...

Diedre Moire Corp.

Claims Examiner MedMal

Reading, PA · On-site

$100K - $140K/yr

Medical Malpractice Liability Claims Examiner - Reading, PA Insurance Claims Examiner Adjuster Specialist Professional Liability Medical Malpractice MedMal Allied Healthcare _ . REMOTE - WORK FROM ...

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Insurance Claims Examiner information

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$40K

$61.6K

$92K

How much do insurance claims examiner jobs pay per year?

As of Jul 1, 2026, the average yearly pay for insurance claims examiner in the United States is $61,600.00, according to ZipRecruiter salary data. Most workers in this role earn between $54,000.00 and $65,500.00 per year, depending on experience, location, and employer.

What does an Insurance Claims Examiner do?

An Insurance Claims Examiner is responsible for reviewing insurance claims to determine their validity and ensure that payouts are made according to policy guidelines. They investigate the details of claims, verify information, and may consult with medical or legal experts. The examiner determines if claims are covered, recommends approval or denial, and helps prevent fraudulent or excessive claims. Their work ensures that policyholders receive fair treatment while protecting the insurance company's financial interests.

What is the difference between Insurance Claims Examiner vs Insurance Adjuster?

AspectInsurance Claims ExaminerInsurance Adjuster
CredentialsTypically requires a high school diploma or equivalent; some roles prefer certifications like CPCU or AICRequires similar credentials; certifications like AIC or CPCU are common
Work EnvironmentOffice-based, reviewing claims and documentationField or office-based, inspecting damages and interviewing claimants
Employer & IndustryInsurance companies, government agenciesInsurance companies, independent adjusting firms
Search & Comparison IntentOften compared for claims processing rolesRelated to claims evaluation and damage assessment

Both Insurance Claims Examiners and Insurance Adjusters work within the insurance industry, handling claims and requiring similar certifications. While Claims Examiners primarily review documentation in office settings, Adjusters often inspect damages in the field. Understanding these differences helps job seekers identify the right role based on work environment and responsibilities.

What are some common challenges Insurance Claims Examiners face in their daily work?

Insurance Claims Examiners often encounter the challenge of balancing thorough investigation with timely claims processing. Reviewing complex documentation, communicating with claimants and other stakeholders, and detecting potential fraud can be demanding, especially when managing a high-volume caseload. Examiners must stay updated on changing regulations and policy guidelines while maintaining objectivity and empathy in sometimes stressful situations. Developing strong organizational and communication skills is key to overcoming these challenges and delivering fair, accurate outcomes.

What are the key skills and qualifications needed to thrive as an Insurance Claims Examiner, and why are they important?

To thrive as an Insurance Claims Examiner, you need a solid understanding of insurance policies, claim procedures, and investigative techniques, typically supported by a bachelor's degree in a related field. Familiarity with claims management software, regulatory compliance tools, and sometimes certifications like AIC (Associate in Claims) are commonly required. Attention to detail, analytical thinking, and effective communication are crucial soft skills for evaluating claims and interacting with claimants and stakeholders. These skills ensure accurate claim assessments, minimize fraudulent payouts, and maintain trust with clients and insurers.
More about Insurance Claims Examiner jobs
What cities are hiring for Insurance Claims Examiner jobs? Cities with the most Insurance Claims Examiner job openings:
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What states have the most Insurance Claims Examiner jobs? States with the most job openings for Insurance Claims Examiner jobs include:
What job categories do people searching Insurance Claims Examiner jobs look for? The top searched job categories for Insurance Claims Examiner jobs are:
What are popular job titles related to Insurance Claims Examiner jobs? For Insurance Claims Examiner jobs, the most frequently searched job titles are:
Insurance Claims Examiner jobs near you
Infographic showing various Insurance Claims Examiner job openings in the United States as of June 2026, with employment types broken down into 76% Full Time, and 24% Part Time. Highlights an 91% Physical, 1% Hybrid, and 8% Remote job distribution, with an average salary of $61,600 per year, or $29.6 per hour.
Commercial Property Claims Examiner II (Remote)

Commercial Property Claims Examiner II (Remote)

California FAIR Plan Association

Los Angeles, CA • On-site, Remote

$85K - $95K/yr

Full-time

Posted 15 days ago

Job description

POSITION SUMMARY
The Commercial Property Examiner II reviews, evaluates and processes complex commercial insurance claims and makes recommendations for resolution. Additionally, this role will examine and authorize commercial insurance claims investigated by independent adjusters. Lastly, the commercial property examiner will review claim forms and other records to determine insurance coverage, ensuring payment recommendations and settlements have been made correctly.
PRINCIPAL DUTIES & RESPONSIBILITIES
  • Manage a caseload of commercial property claims from assignment through resolution.
  • Examine commercial claims investigated by independent adjusters to determine the extent of insurance coverage and validity of the claims.
  • Review and adjust commercial loss reserves, correspondence, reports, verify coverage and authorize payments submitted by independent adjusters.
  • Collaborate with internal personnel and/or legal counsel on claims involving litigation.
  • Investigate, evaluate, and adjust claims, applying technical knowledge and human relations skills to promote fair and prompt settlement of claims.
  • Oversee independent adjuster files to ensure they have followed CFP IA Guidelines.
  • Verify and analyze data used in settling claims to ensure validity and that settlement is in accordance with company practices and procedures.
  • Maintain compliance with the Department of Insurance and Company procedures.
  • Identify fraud or illegal activity indicators and follow internal processes to refer the claims to the appropriate personnel for follow up.
  • Promptly negotiates settlements ensuring the settlement reflects the insured losses while confirming the insurer is protected from invalid claims

ADDITIONAL DUTIES & RESPONSIBILITIES
Commercial Claims Examiner II: The Commercial Property Examiner II role will focus on commercial claims up to $500,000
KNOWLEDGE & SKILL REQUIREMENTS
  • Bachelor's degree or equivalent.
  • 5+ years of property claims adjusting experience, including 2+ years commercial property claims preferred.
  • Excellent oral and written communication skills.
  • Working experience with MS-Office (especially Word and Excel).
  • Comprehensive understanding of policy contract/statutes and claims processes.
  • Certified in CEA and Fair Claims Settlement Practices.

ADDITIONAL REQUIREMENTS (PRIOR EXPERIENCE)
Commercial Claims Examiner II: 2 years of commercial experience.

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