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Requirements and Responsibilities

Claims Examiner V reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner V studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner V determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner V works autonomously. Goals are generally communicated in "solution" or project goal terms. May provide a leadership role for the work group through knowledge in the area of specialization. Works on advanced, complex technical projects or business issues requiring state of the art technical or industry knowledge. To be a Claims Examiner V typically requires 10+ years of related experience.

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