An insurance claim examiner is a professional responsible for evaluating claims submitted to an insurance company for payment. His primary duties are to ensure that claims are valid and that the company pays the proper amount for each. In order to become an insurance claim examiner, you will need a certain amount of education — usually a minimum of a high school diploma or its equivalent — as well as related work experience, and you'll probably need to earn a certification from a regulating agency. You will also need to find and apply for jobs and complete any required background checks and company-specific training.
The minimum education needed to become an insurance claim examiner will vary based on your location and the company for which you wish to work. In most places, a high school diploma is the minimum required by law. A few regulating agencies, however, require you to have at least a two-year degree. Many employers also require such a degree, and they often give preference to candidates with a four-year degree.
In some cases, regulating agencies do not require experience to earn certification. Most insurance companies, however, will want you to have some experience working within the industry before you become an insurance claim examiner. This might be as a sales agent, customer service professional, claims adjuster or other insurance professional. You may also want to find an examiner trainee position and, in fact, some regulatory agencies and employer companies will require you to take this step.
Insurance companies may also want you to have experience in the specific field for which you will be examining. For example, if you intend to become an insurance claim examiner for auto policies, a basic knowledge of auto mechanics and body work will be helpful. Experience and education within your field is especially important for examiners in the health sector.
In the vast majority of cases, you will need to be certified by a governmental or regulatory agency in order to become an insurance claim examiner. This almost always involves passing one or more detailed examinations covering both your specific field of expertise and insurance law in general. It may also involve serving in a trainee capacity for a specified length of time and/or completing a formal training course. In some areas, you must obtain a certification in each sector for which you wish to become an examiner.
As with any job, you'll need to job hunt and apply for positions to become an insurance claim examiner. This means creating and distributing a professional resume, searching and applying for positions, and passing interviews. You may also need to pass background or credit checks. Upon being hired, many companies also require you to complete a company-specific training program to familiarize you with internal processes and procedures.
