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Tpa Examiner Jobs (NOW HIRING)

AIG

Complex Claims Director - TPA Oversight

Chicago, IL · On-site

$104K - $125K/yr

Successfully complete required State licensing examinations and continuing education requirement ... Partner with TPA Governance and Relationship Management to help TPA's and Insureds comply with ...

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Tpa Examiner information

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How much do tpa examiner jobs pay per year?

As of Sep 10, 2026, the average yearly pay for tpa examiner in the United States is $61,362.00, according to ZipRecruiter salary data. Most workers in this role earn between $48,000.00 and $69,500.00 per year, depending on experience, location, and employer.

What is a TPA examiner?

TPA Examiners are professionals who work for Third Party Administrators (TPAs), organizations that manage various aspects of employee benefit plans, such as retirement or health insurance, on behalf of employers. Their main responsibilities include reviewing claims, ensuring compliance with regulations, and processing plan transactions. TPA Examiners play a critical role in making sure that participant requests and plan operations are handled accurately and efficiently. They often interact with plan sponsors, participants, and other service providers to resolve discrepancies and answer questions. This position requires strong attention to detail, regulatory knowledge, and customer service skills.

What are the key skills and qualifications needed to thrive as a TPA examiner?

To excel as a TPA Examiner, you need a solid understanding of insurance claims processing, policy interpretation, and relevant regulatory compliance, often supported by experience in claims management or an insurance-related degree. Familiarity with claims management software, document management systems, and sometimes industry certifications like AIC or CPCU is typically required. Attention to detail, strong analytical skills, and effective communication are crucial soft skills for investigating claims and interacting with clients and stakeholders. These capabilities ensure accurate and efficient claims adjudication, regulatory compliance, and strong client relationships.

What are the typical daily challenges faced by a TPA examiner, and how can new hires best prepare for them?

TPA Examiners often manage a high volume of claims and must ensure each is processed accurately and in compliance with client and regulatory requirements. Common challenges include balancing competing deadlines, interpreting complex policy language, and maintaining clear communication with clients, claimants, and medical providers. New hires can best prepare by developing strong organizational skills, familiarizing themselves with relevant regulations (such as ERISA), and proactively seeking clarification when encountering unfamiliar scenarios. Embracing ongoing learning and collaborating with experienced team members can also help newcomers navigate the role effectively.

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

AspectTpa ExaminerInsurance Claims Adjuster
Required CredentialsTypically requires a license, insurance knowledge, and sometimes a certification in claims or insuranceRequires licensing, insurance knowledge, and often a claims adjusting certification
Work EnvironmentOffice-based, reviewing claims, conducting examinations, and assessing damagesField and office-based, investigating claims, inspecting damages, and negotiating settlements
Employer & Industry UsageUsed mainly by third-party administrators, insurance companies, and healthcare providersEmployed by insurance companies, independent adjusting firms, and public adjusting agencies

The Tpa Examiner and Insurance Claims Adjuster roles share similar credentials and work environments, focusing on claims assessment. However, Tpa Examiners primarily review claims for third-party administrators, often in healthcare or insurance contexts, while Insurance Claims Adjusters investigate and settle claims directly for insurance companies. Both roles require licensing and insurance knowledge, but their specific duties and employer types differ slightly.

What cities are hiring for Tpa Examiner jobs?

Cities with the most Tpa Examiner job openings:

What states have the most Tpa Examiner jobs?

States with the most job openings for Tpa Examiner jobs include:

What are popular job titles related to Tpa Examiner jobs?

For Tpa Examiner jobs, the most frequently searched job titles are:

Infographic showing various Tpa Examiner job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 87% Full Time, 9% Part Time, 1% Temporary, 1% Contract, and 1% Nights. Highlights an 84% Physical, 6% Hybrid, and 10% Remote job distribution, with an average salary of $61,362 per year, or $29.5 per hour.

Commercial General Liability Claims Examiner | Remote

East Orange, NJ • On-site, Remote

KING'S INSURANCE STAFFING LLC
See more jobs at KING'S INSURANCE STAFFING LLCexternal

$36 - $37.50/hr

Full-time

Medical, Dental, Vision

Re-posted 3 hours ago

Job description

Our client, a well-established organization within the Property & Casualty insurance industry, is looking to add an experienced Commercial General Liability Claims Examiner to its New Jersey claims team. In this role, the Claims Adjuster will manage a caseload of moderate to complex Commercial General Liability claims from initial assignment through final resolution. Claims will include Premises Liability, Slip and Falls, Bodily Injury, and other General Liability exposures, including litigated matters. The ideal candidate will have strong coverage analysis, investigation, negotiation, and litigation management experience within a carrier or TPA environment.
 
This is a Temporary-to-Hire position with the ability to work remotely for candidates residing in New Jersey.
 
Key Responsibilities
  • Independently manage Commercial General Liability claims from initial assignment through resolution.
  • Investigate coverage, liability, and damages to determine appropriate claim strategy and exposure.
  • Handle a variety of General Liability losses, including Premises Liability, Slip and Falls, and Bodily Injury claims.
  • Review and interpret policy language to determine coverage under primary and excess policies.
  • Manage litigated claims while working closely with defense counsel on case strategy, discovery, evaluations, and settlement opportunities.
  • Communicate regularly with insureds, claimants, attorneys, brokers, and other involved parties throughout the claims process.
  • Evaluate medical documentation, investigative findings, legal developments, and other claim-related information.
 
Qualifications
  • 5+ years of experience handling Commercial General Liability claims.
  • Experience managing litigated General Liability files is required.
  • Strong understanding of coverage analysis involving primary and excess insurance.
  • Previous claims experience with an insurance carrier and/or Third-Party Administrator (TPA).
  • Experience handling Premises Liability, Slip and Falls, and Bodily Injury exposures preferred.
  • Strong investigation, negotiation, organization, and written communication skills.
  • Ability to independently manage a caseload while meeting deadlines and maintaining claim quality standards.
  • Bachelor’s degree preferred.
  • Must currently reside in New Jersey.
 
Salary & Benefits
  • $40.00/hr to $45.00/hr (depending on experience)
  • Competitive Medical, Dental, and Vision Benefits while on assignment
  • Opportunity to transition to permanent employee
  • Flex schedule and ability to work remotely