Claims Adjuster Job Description [Updated for 2025]

In the ever-evolving insurance industry, the role of claims adjusters is becoming increasingly critical.

As unpredictable events and disasters continue to unfold, the demand for proficient individuals who can accurately evaluate insurance claims and determine payouts is on the rise.

But let’s delve deeper: What’s truly expected from a claims adjuster?

Whether you are:

An aspirant looking to understand the nuances of this role,
A hiring manager aiming to outline the perfect candidate,
Or simply curious about the intricacies of claims adjustment,

You’re in the right place.

Today, we present a versatile claims adjuster job description template, created for effortless posting on job boards or career sites.

Let’s dive right into it.

Contents show

Claims Adjuster Duties and Responsibilities

Claims Adjusters evaluate and investigate insurance claims to determine the extent of the insuring company’s liability.

They play a crucial role in ensuring that the claims process is handled efficiently and satisfactorily for all parties involved.

Their duties and responsibilities include:

Investigating and analyzing insurance claims for property damage, bodily injury, or liability claims
Reviewing police reports, medical treatment records, or damage estimates to determine the extent of liability
Interviewing claimants, witnesses, medical specialists, or employers to gather pertinent information
Negotiating with claimants to settle claims
Preparing detailed reports of each claim, documenting the decision-making process
Coordinating with legal counsel in the event of a lawsuit
Assessing whether more investigation is necessary when discrepancies arise
Keeping claimants informed about claim progress, answering their questions and addressing their concerns
Maintaining professional knowledge and staying updated with new laws and regulations in the insurance industry
Ensuring compliance with company procedures and industry regulations

Claims Adjuster Job Description Template

Job Brief

We are seeking a skilled Claims Adjuster to join our team.

This role involves investigating insurance claims by interviewing claimants and witnesses, consulting police and hospital records, and inspecting property damage to determine the extent of the company’s liability.

The ideal candidate has a keen eye for detail, excellent negotiation skills, and the ability to interpret insurance policies and legal documents.

Responsibilities

Investigate and process insurance claims filed by clients
Interview claimants to get a first-hand account of the incident
Inspect property damage to determine the extent of insurance liability
Review and evaluate insurance policy to determine coverage
Prepare and present reports of investigations
Negotiate claim settlements and recommend litigation when settlement cannot be reached
Consult with legal counsel on claims when necessary
Keep records of claims and report on adjustments

Qualifications

Proven work experience as a claims adjuster or similar role
Familiarity with insurance policies and claim procedures
Working knowledge of software for processing claims
Excellent negotiation and communication skills
Strong investigative and analytical skills
Attention to detail and strong organizational skills
A degree in Business Administration, Finance, or a related field
Professional certification (e.g. Associate in Claims (AIC), Certified Property Casualty Underwriter (CPCU)) will be a plus

Benefits

401(k)
Health insurance
Dental insurance
Retirement plan
Paid time off
Professional development opportunities

Additional Information

Job Title: Claims Adjuster
Work Environment: Office setting with options for remote work. Some travel may be required for site inspections or meetings.
Reporting Structure: Reports to the Claims Manager or Head of Claims.
Salary: Salary is based upon candidate experience and qualifications, as well as market and business considerations.
Pay Range: $45,000 minimum to $75,000 maximum
Location: [City, State] (specify the location or indicate if remote)
Employment Type: Full-time
Equal Opportunity Statement: We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
Application Instructions: Please submit your resume and a cover letter outlining your qualifications and experience to [email address or application portal].

What Does a Claims Adjuster Do?

Claims Adjusters work for insurance companies where they inspect, investigate, and evaluate insurance claims.

Their primary role is to decide whether an insurance company must pay a claim, and if so, how much.

They assess property damage and personal injuries to determine the financial cost of incidents like accidents, fires, or thefts.

This involves conducting on-site inspections, interviewing claimants and witnesses, and consulting with professionals such as engineers, architects, and doctors.

Claims Adjusters also negotiate settlements with claimants, ensuring that the payout is fair both for the claimant and the insurance company.

They may need to consult with legal counsel if a claim is contested.

In addition to this, they are responsible for maintaining records of their investigations, settlements, and general findings.

These records can be useful in future claims handling or in the case of legal proceedings.

Some Claims Adjusters may also be tasked with identifying fraudulent claims by thoroughly investigating the circumstances of the claim and looking for inconsistencies or discrepancies.

Their ultimate goal is to provide a fair resolution in a timely manner, helping both the claimant and the insurance company reach a satisfactory outcome.

Claims Adjuster Qualifications and Skills

Claims Adjusters utilize a blend of technical skills, analytical abilities, and communication skills to evaluate and settle insurance claims, including:

Strong analytical skills to assess damages or losses and determine the company’s liability in various claims.
Excellent communication and negotiation skills to communicate findings, explain coverage, and negotiate settlements with claimants.
Detail-oriented to scrutinize various documents, reports, and claims forms to ensure accuracy and compliance with policy terms.
Interpersonal skills to interact empathetically with claimants who may be dealing with stressful situations.
Knowledge of legal and insurance terms, practices, and policies to accurately assess and process claims.
Decision-making skills to determine the legitimacy of a claim and decide on its appropriate settlement.
Time management skills to handle multiple claims simultaneously, prioritize tasks, and meet deadlines.
Computer proficiency to use claims software and systems to record and track claims.

Claims Adjuster Experience Requirements

Claims adjusters typically require a minimum of a high school diploma or equivalent, though many employers prefer candidates with a bachelor’s degree.

However, practical experience is just as significant in this role.

Entry-level claims adjusters can gain relevant experience through internships or part-time roles in insurance companies.

They can also gain relevant knowledge from customer service or administrative roles, which equip them with the necessary skills for interacting with policyholders and handling paperwork.

Candidates with 1 to 3 years of experience often have a deeper understanding of insurance policies, claims investigations, and negotiation tactics.

This experience may have been gained in roles such as Claims Assistant or Junior Claims Adjuster.

Those with more than 3 years of experience usually have advanced skills in evaluating complex claims, determining the appropriate payout, and resolving disputes.

They may have also developed soft skills, such as empathy and patience, which are vital when dealing with distressed policyholders.

Claims adjusters with over 5 years of experience often have a strong background in managing multiple claims simultaneously, and they may be ready to take on leadership roles such as Claims Supervisor or Claims Manager.

Such roles require extensive experience in overseeing claims processes, training junior adjusters, and ensuring compliance with state and company regulations.

Claims Adjuster Education and Training Requirements

Claims Adjusters typically require a bachelor’s degree in business, finance, or a related field.

However, some employers may accept equivalent work experience in place of a degree.

They also need a solid understanding of insurance policies and the ability to interpret them, as well as an understanding of medical terminology and home construction.

In most states, Claims Adjusters need to be licensed.

The licensing requirements vary by state, but generally involve completing pre-licensing education or passing a licensing exam.

Many Claims Adjusters go on to earn professional certifications, such as the Associate in Claims (AIC) or the Chartered Property Casualty Underwriter (CPCU), to demonstrate expertise in their field.

Ongoing education is important in this role as adjusters need to stay updated on new laws and regulations.

Some employers may also prefer candidates with prior experience in insurance, construction, or a related industry.

Claims Adjuster Salary Expectations

A Claims Adjuster can expect to earn an average salary of $59,962 (USD) per year.

The actual earnings can fluctuate based on factors such as experience, certifications, the complexity of cases managed, and the geographical location.

Claims Adjuster Job Description FAQs

What skills does a Claims Adjuster need?

A Claims Adjuster should possess excellent negotiation and interpersonal skills to handle discussions with claimants and other parties involved in the claim process.

They should have analytical abilities to assess the validity of a claim and determine the appropriate payment.

Other key skills include being detail-oriented to manage documentation and an understanding of insurance laws and regulations.

Do Claims Adjusters need a degree?

Most employers require Claims Adjusters to hold a bachelor’s degree, but the field of study can vary.

Some might prefer degrees in business or economics, while others might accept diverse educational backgrounds.

However, all Claims Adjusters must be licensed in their state, which typically involves passing an exam.

What should you look for in a Claims Adjuster resume?

When assessing a Claims Adjuster resume, look for previous experience in the insurance industry and experience in handling claims.

Knowledge of insurance laws and regulations is critical, so consider any relevant coursework or certifications.

Also, look for evidence of strong interpersonal, negotiation, and analytical skills, which are crucial in this role.

What qualities make a good Claims Adjuster?

A good Claims Adjuster is thorough and detail-oriented, ensuring all aspects of a claim are investigated and documented.

They should be able to communicate effectively with various parties, including claimants, witnesses, and insurance representatives.

A good Claims Adjuster also has strong analytical skills to assess the legitimacy of a claim and determine appropriate compensation.

What is the difference between a Claims Adjuster and a Claims Examiner?

While both roles work with insurance claims, a Claims Adjuster typically works in the field, investigating the incident, interviewing claimants, and negotiating settlements.

A Claims Examiner, on the other hand, primarily works in an office setting, reviewing the work of Adjusters, approving or denying claims, and ensuring adherence to company policies and insurance laws.

Conclusion

And there we have it.

Today, we have unveiled the true essence of being a claims adjuster.

Surprise?

It’s not just about handling insurance claims.

It’s about carefully evaluating, examining and settling claims, one case at a time.

With our comprehensive claims adjuster job description template and real-world instances, you’re prepared to make your mark.

But why end there?

Explore further with our job description generator. It’s your next stage to creating detailed job postings or refining your resume to perfection.

Bear in mind:

Each claim you settle contributes to a greater narrative.

Let’s shape that narrative. Together.