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Become A Workers' Compensation Claims Adjuster

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Working As A Workers' Compensation Claims Adjuster

  • Identifying Objects, Actions, and Events
  • Interacting With Computers
  • Getting Information
  • Documenting/Recording Information
  • Processing Information
  • Unpleasant/Angry People

  • Mostly Sitting

  • Make Decisions

  • Stressful

  • $74,350

    Average Salary

What Does A Workers' Compensation Claims Adjuster Do At Gallagher

* Exercises proper judgment and decision making to analyze the claims exposure to determine the proper course of action and to appropriately settle the claim.
* Interacts extensively with various parties involved in the claim process.
* Handles claims consistent with clients' and corporate policies, procedures and "best practices" and also in accordance with any statutory, regulatory and ethics requirements.
* Documents and communicates all claim activity timely and effectively and in a manner which supports the outcome of the claim file.
* Incumbents at this level should be able to work at full case load capacity.
* Additional Considerations

What Does A Workers' Compensation Claims Adjuster Do At Gallagher

* Interfaces with, and obtains information from, claimants, clients, vendors and other resources.
* Conducts limited investigations, appropriately documents information, evaluates losses and exposures and recommends appropriate settlements to conclude claims.
* Analyzes and evaluates various coverage, liability, exposure and damage issues.
* Maintains effective and ongoing communication with various internal and external contacts

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How To Become A Workers' Compensation Claims Adjuster

A high school diploma or equivalent is typically required for a person to work as an entry-level claims adjuster, examiner, or investigator. Higher level positions may require a bachelor’s degree or some insurance-related work experience. Auto damage appraisers typically have either a postsecondary nondegree award or work experience in identifying and estimating the cost of automotive repair.

Education

A high school diploma or equivalent is typically required for a person to work as an entry-level claims adjuster, examiner, or investigator. However, employers sometimes prefer to hire applicants who have a bachelor’s degree or some insurance-related work experience or vocational training. Auto damage appraisers typically have either a postsecondary nondegree award or experience working in an auto repair shop, identifying and estimating the cost of automotive repair.

The varying types of work in these occupations can require different backgrounds or different college coursework. For example, a business or an accounting background might be best for someone who wishes to specialize in claims of financial loss due to strikes, equipment breakdowns, or merchandise damage. College training in architecture or engineering is helpful for adjusting industrial claims, such as those involving damage from fires or other accidents. A legal background is beneficial to someone handling workers’ compensation and product liability cases. A medical background is useful for examiners working on medical and life insurance claims.

Although auto damage appraisers are not required to have a college education, most companies prefer to hire people who have the formal training, experience, or knowledge and technical skills to identify and estimate the cost of automotive repair. Many vocational schools and some community colleges offer programs in auto body repair and teach students how to estimate the cost of repairing damaged vehicles.

For investigator jobs, a high school diploma or equivalent is the typical education requirement. Most insurance companies prefer to hire people trained as law enforcement officers, private investigators, claims adjusters, or examiners, because these workers have good interviewing and interrogation skills.

Training

At the beginning of their careers, claims adjusters, examiners, and investigators work on small claims, under the supervision of an experienced worker. As they learn more about claims investigation and settlement, they are assigned larger, more complex claims.

Auto damage appraisers typically get on-the-job training, which may last several months. This training usually involves working under the supervision of a more experienced appraiser while estimating damage costs, until the employer decides that the trainee is ready to do estimates on his or her own.

Licenses, Certifications, and Registrations

Licensing requirements for claims adjusters, appraisers, examiners, and investigators vary by state. Some states have few requirements; others require either completing prelicensing education or receiving a satisfactory score on a licensing exam (or both).

In some states, claims adjusters employed by insurance companies do not have to become licensed themselves because they can work under the company license.

Public adjusters may need to meet separate or additional requirements.

Some states that require licensing also require a certain number of continuing education credits per year to renew the license. Federal and state laws and court decisions affect how claims must be handled and what insurance policies can and must cover. Examiners working on life and health claims must stay up to date on new medical procedures and the latest prescription drugs. Examiners working on auto claims must be familiar with new car models and the most recent repair techniques. In order to fulfill their continuing education requirements, workers can attend classes or workshops, write articles for claims publications, or give lectures and presentations.

Important Qualities

Analytical skills. Adjusters and examiners must both evaluate whether the insurance company is obligated to pay a claim and determine the amount to pay. Adjusters must carefully consider various pieces of information to reach a decision.

Communication skills. Claims adjusters and investigators must get information from a wide range of people, including claimants, witnesses, and medical experts. They must know the right questions to ask in order to gather the information they need.

Detail oriented. Adjusters, appraisers, examiners, and investigators must carefully review documents and damaged property, because small details can have large financial consequences.

Interpersonal skills. Adjusters, examiners, and investigators often meet with claimants and others who may be upset by the situation that requires a claim or by the settlement the company is offering. These workers must be understanding, yet firm with their company’s policies.

Math skills. Appraisers must be able to calculate property damage.

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Workers' Compensation Claims Adjuster jobs

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Workers' Compensation Claims Adjuster Career Paths

Workers' Compensation Claims Adjuster
Claims Supervisor Operations Manager Business Manager
Business Operations Manager
8 Yearsyrs
Senior Claims Adjuster Claims Manager
Claims Director
12 Yearsyrs
Compensation Adjuster Senior Claims Adjuster
Claims Manager
8 Yearsyrs
Claim Processor Office Manager Human Resources Coordinator
Director Of Human Resources
10 Yearsyrs
Claim Specialist Account Manager Sales Manager
District Manager
7 Yearsyrs
Senior Claims Representative Adjuster
General Adjuster
11 Yearsyrs
Office Manager Dispatcher Operation Supervisor
Logistics Manager
7 Yearsyrs
Case Manager Assistant Director General Manager
Managing Partner
9 Yearsyrs
Claim Specialist Billing Specialist Operations Manager
Operations Director
9 Yearsyrs
Claim Processor Billing Specialist Specialist
Operations Manager
7 Yearsyrs
Claims Supervisor Claims Manager Project Manager
Owner/Manager
6 Yearsyrs
Case Manager Program Manager General Manager
President Of Operations
11 Yearsyrs
Legal Assistant Project Manager General Manager
Regional Director
9 Yearsyrs
Senior Claims Adjuster Claim Specialist Account Manager
Regional Manager
8 Yearsyrs
Worker's Compensation Claims Examiner Claim Processor Claims Adjuster
Senior Claims Adjuster
7 Yearsyrs
Senior Claims Representative Claim Processor
Senior Claims Examiner
7 Yearsyrs
Worker's Compensation Claims Examiner Senior Claims Examiner
Senior Claims Representative
6 Yearsyrs
Compensation Adjuster Claim Specialist
Senior Claims Specialist
7 Yearsyrs
Office Manager Property Manager Portfolio Manager
Senior Risk Analyst
7 Yearsyrs
Legal Assistant Office Manager Licensed Practical Nurse
Unit Manager
6 Yearsyrs
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Workers' Compensation Claims Adjuster Demographics

Gender

  • Female

    70.4%
  • Male

    27.2%
  • Unknown

    2.4%

Ethnicity

  • White

    82.6%
  • Hispanic or Latino

    9.6%
  • Asian

    6.3%
  • Unknown

    1.1%
  • Black or African American

    0.3%
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Languages Spoken

  • Spanish

    56.3%
  • German

    6.3%
  • Ilocano

    6.3%
  • Japanese

    6.3%
  • French

    6.3%
  • Carrier

    6.3%
  • Tagalog

    6.3%
  • Cebuano

    6.3%
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Workers' Compensation Claims Adjuster

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Workers' Compensation Claims Adjuster Education

Workers' Compensation Claims Adjuster

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Top Skills for A Workers' Compensation Claims Adjuster

WorkersCompensationClaimsMedicalTreatmentInjuryEmployersMedicalProvidersLossMedicalBillsDefenseCounselCustomerServiceLiabilityWorkersCompensationLawsPermanentDisabilityAdjustersMedicalRecordsComputerProgramsFraudSafetyMedicalReportsActionPlansNewClaims

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Top Workers' Compensation Claims Adjuster Skills

  1. Workers Compensation Claims
  2. Medical Treatment
  3. Injury
You can check out examples of real life uses of top skills on resumes here:
  • Investigate and evaluate workers compensation claims for National Account clients in PA, NJ and Delaware jurisdictions.
  • Authorize medical treatment, medications and benefits.
  • Obtain statements from witnesses and employers when necessary to verify that the injury arose in the course and scope of employment.
  • Interacted with Employers/Insured's with locations in multiple states.
  • Provided service to customers including claimants, medical providers, store/club/distribution center personnel, and legal counsel.

Top Workers' Compensation Claims Adjuster Employers

Workers' Compensation Claims Adjuster Videos

Workers Compensation Claims - When you can make two claims for your injuries

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