Occupations/13-1031.00
Claims Adjusters, Examiners, and Investigators
Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confer with legal counsel on claims requiring litigation. May also settle insurance claims.
Usually a four-year bachelor’s degree.
AI automation risk
78%
Higher automation risk
Human characteristics
53%
Balanced human and task mix
Task orientation
79%
Higher automation risk
A day in this job
- Mostly routine
Examine claims forms and other records to determine insurance coverage.
- Mostly routine
Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
- Task
Analyze information gathered by investigation and report findings and recommendations.
The tasks we can read here lean routine. That sits next to the AI risk rank — it is not a forecast that the job disappears.
Core tasks
- 01Examine claims forms and other records to determine insurance coverage.
- 02Analyze information gathered by investigation and report findings and recommendations.
- 03Pay and process claims within designated authority level.
- 04Investigate, 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.
- 05Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
- 06Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
Model drivers (O*NET 1–5)
- Repeating same tasks4.51
- Degree of automation2.98
- Time sitting4.62
- Originality (ability)2.62
- Conflict situations4.03
- Hands-on objects/tools3.20
- Outdoors / weather1.67
- Disease exposure1.10
- Decision freedom4.51
Top abilities
- Written Comprehension4.38
- Oral Expression4.12
- Oral Comprehension4.12
- Inductive Reasoning4.00
- Deductive Reasoning4.00
- Written Expression3.88
- Near Vision3.88
- Speech Clarity3.62
Essential skills
- Reading Comprehension4.12
- Active Listening4.00
- Writing3.62
- Speaking3.88
- Mathematics2.88
- Science1.38
- Critical Thinking4.00
- Active Learning3.25
- Learning Strategies2.50
- Monitoring3.38
CIP matches
Schools offering related programs
12 of 63 shown
Earnings are College Scorecard medians for that program, 1 and 2 years after completion. A dash means the Department suppressed the cell or the campus is not in the field file.
| Institution | Program | Tuition | Admit | Grad 6-yr | Earnings |
|---|---|---|---|---|---|
City Colleges of Chicago-Wilbur Wright College Chicago, IL · Public | Health/Medical Claims Examiner 51.0715 | $4,600 | 100% | 27% | 1 yr $144,240 2 yr $182,280 Master's · CIP 51.07 |
University of Southern California Los Angeles, CA · Private nonprofit | Health/Medical Claims Examiner 51.0715 | $68,200 | 12% | 92% | 1 yr $104,749 2 yr $88,096 Master's · CIP 51.07 |
Columbia University in the City of New York New York, NY · Private nonprofit | Health/Medical Claims Examiner 51.0715 | $68,200 | 4% | 96% | 1 yr $90,049 2 yr $87,310 Master's · CIP 51.07 |
University of Michigan-Ann Arbor Ann Arbor, MI · Public | Health/Medical Claims Examiner 51.0715 | $17,700 | 18% | 93% | 1 yr $89,044 2 yr $87,112 Master's · CIP 51.07 |
New York University New York, NY · Private nonprofit | Health/Medical Claims Examiner 51.0715 | $60,400 | 12% | 88% | 1 yr $87,420 2 yr $80,326 Master's · CIP 51.07 |
Howard University Washington, DC · Private nonprofit | Health/Medical Claims Examiner 51.0715 | $33,200 | 53% | 65% | 1 yr $85,264 2 yr $79,631 Master's · CIP 51.07 |
Virginia Polytechnic Institute and State University Blacksburg, VA · Public | Health/Medical Claims Examiner 51.0715 | $15,200 | 57% | 86% | 1 yr $84,653 2 yr $72,901 Master's · CIP 51.07 |
Georgetown University Washington, DC · Private nonprofit | Health/Medical Claims Examiner 51.0715 | $65,400 | 12% | 95% | 1 yr $69,338 2 yr $70,176 Bachelor's · CIP 51.07 |
Georgia State University Atlanta, GA · Public | Health/Medical Claims Examiner 51.0715 | $9,200 | 67% | 56% | 1 yr $68,778 2 yr $95,739 Master's · CIP 51.07 |
University of Wisconsin-Madison Madison, WI · Public | Insurance 52.1701 | $11,200 | 49% | 89% | 1 yr $68,563 2 yr $66,821 Bachelor's · CIP 52.17 |
Boston University Boston, MA · Private nonprofit | Health/Medical Claims Examiner 51.0715 | $65,200 | 14% | 89% | 1 yr $67,042 2 yr $63,681 Master's · CIP 51.07 |
University of Florida Gainesville, FL · Public | Health/Medical Claims Examiner 51.0715 | $6,400 | 23% | 89% | 1 yr $61,728 2 yr $68,499 Master's · CIP 51.07 |