Insurance company claims examiners usually supervise claims adjusters. They make sure that payments and settlements have been made in accordance with company practices and procedures and that the adjuster’s repair estimates are accurate.
Claims examiners report overpayments, underpayments, and irregularities. They confer with attorneys, medical personnel, and experts on claims that go to court.
They also help guard against insurance fraud, whether it involves false medical claims, faked documents, or even murder-for-profit.
That’s why, in addition to an ability to deal with the complexities of insurance regulations and claim procedures, it is important to be able to tell if a given claim makes sense.
When the details don’t add up, it can be very satisfying to apply your knowledge and skills to uncover the suspected fraud and see to it that the perpetrators are brought to justice.