What are the roles and functions of an insurance claims examiner?

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Most of the time, sales comes to mind on the subject of employment in insurance companies. However, the latter have a lot in common with most corporations in terms of departments. They have finance departments, human resources, logistics, marketing, and so on.

And like other industries, the insurance sector is host to unique jobs. According to Delos H. Yancey, president, chairman, and CEO of State Mutual Insurance, an insurance claims examiner is one of these unique positions answering for the following roles and functions:

The bulk of work of an insurance claims examiner is centered on investigating insurance claims. The insurance claims examiner validates the claims made by a policy holder before the insurance company can process a payout.

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An insurance claim is handed to an investigator if the insurance agent deems an incident worthy of examination. For example, a client that had unnecessary health treatments or has an unclear cause of death warrants an investigation.

There is also a great deal of administrative work handled by insurance claims examiners. They have to encode claims payments or payouts, revise claims and attach accompanying documents for these accounts, file, organize, and maintain an inventory of claims that need further analysis, and so on.

Insurance examiners aren’t just employed by insurance companies. According to Delos H. Yancey, the U.S. Bureau of Labor Statistics showed that while 32% of examiners in 2010 were employed by insurance companies, 18% worked for the government and 17% worked in insurance-related companies.

Led by Delos H. Yancey III, State Mutual Insurance helps older Americans maintain a sense of security through products designed specifically for their benefit. The mutual insurance company has been serving insurance policy holders for over 75 years—longevity that is testament to the quality of its products. Visit the company's website for more on its services and history.