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Career profile Claims Analyst

Also known as Claim Representative, Claims Adjuster, Claims Analyst, Claims Examiner, Claims Representative, Claims Specialist, Corporate Claims Examiner, General Adjuster, Home Office Claim Specialist, Litigation Claim Representative

Claims Analyst

Also known as Claim Representative, Claims Adjuster, Claims Analyst

Interests Profile
  • Conventional
  • Enterprising
  • Investigative
Pay Range
$41,950 - $103,610 (annual)
Required Skills
  • Reading Comprehension
  • Critical Thinking
  • Active Listening
Knowledge Areas
  • Customer and Personal Service
  • Law and Government
  • Administrative
Core tasks
  • Negotiate claim settlements or recommend litigation when settlement cannot be negotiated.
  • Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit.
  • Attend mediations or trials.
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What does a Claims Analyst do?

Claims Analysts review settled claims to determine that payments and settlements are made in accordance with company practices and procedures.

In addition, Claims Analysts

  • confer with legal counsel on claims requiring litigation,
  • may also settle insurance claims.

What kind of tasks does a Claims Analyst perform regularly?

Claims Analysts are often responsible for overseeing or executing some or all of the following tasks:

  • Examine claims forms and other records to determine insurance coverage.
  • Analyze information gathered by investigation and report findings and recommendations.
  • Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
  • Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
  • Investigate and assess damage to property and create or review property damage estimates.
  • Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
  • Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
  • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
  • Resolve complex, severe exposure claims, using high service oriented file handling.
  • Pay and process claims within designated authority level.
  • Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
  • Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
  • Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
  • Refer questionable claims to investigator or claims adjuster for investigation or settlement.
  • Collect evidence to support contested claims in court.
  • Confer with legal counsel on claims requiring litigation.
  • Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
  • Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
  • Present cases and participate in their discussion at claim committee meetings.

The above responsibilities are specific to Claims Analysts. More generally, Claims Analysts are involved in several broader types of activities:

Working with Computers
Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information.
Getting Information
Observing, receiving, and otherwise obtaining information from all relevant sources.
Making Decisions and Solving Problems
Analyzing information and evaluating results to choose the best solution and solve problems.
Communicating with Supervisors, Peers, or Subordinates
Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person.
Resolving Conflicts and Negotiating with Others
Handling complaints, settling disputes, and resolving grievances and conflicts, or otherwise negotiating with others.

What is a Claims Analyst salary?

The median salary for a Claims Analyst is $68,270, and the average salary is $70,650. Both the median and average roughly describe the middle of the Claims Analyst salary range, but the average is more easily affected by extremely high or low salaries.

Many Claims Analysts earn significantly more or less than the average, due to several factors. About 10% of Claims Analysts earn less than $41,950 per year, 25% earn less than $52,160, 75% earn less than $85,820, and 90% earn less than $103,610.

Between the years of 2020 and 2030, the number of Claims Analysts is expected to change by -2.7%, and there should be roughly 24,000 open positions for Claims Analysts every year.

Median annual salary
$68,270
Typical salary range
$41,950 - $103,610
Projected growth (2020 - 2030)
-2.7%

What personality traits are common among Claims Analysts?

Interests

Career interests describe a person's preferences for different types of working environments and activities. When a person's interest match the demands of an occupation, people are usually more engaged and satisfied in that role.

Compared to most occupations, those who work as a Claims Analyst are usually higher in their Conventional and Enterprising interests.

Claims Analysts typically have very strong Conventional interests. Conventional occupations frequently involve following set procedures and routines. These occupations can include working with data and details more than with ideas. Usually there is a clear line of authority to follow.

Also, Claims Analysts typically have strong Enterprising interests. Enterprising occupations frequently involve starting up and carrying out projects. These occupations can involve leading people and making many decisions. Sometimes they require risk taking and often deal with business.

Values

People differ in their values, or what is most important to them for building job satisfaction and fulfillment.

Compared to most people, those working as a Claims Analyst tend to value Support, Independence, and Working Conditions.

Most importantly, Claims Analysts moderately value Support. Occupations that satisfy this work value offer supportive management that stands behind employees.

Second, Claims Analysts moderately value Independence. Occupations that satisfy this work value allow employees to work on their own and make decisions.

Lastly, Claims Analysts moderately value Working Conditions. Occupations that satisfy this work value offer job security and good working conditions.

Psychological Demands

Each occupation brings its own set of psychological demands, which describe the characteristics necessary to perform the job well.

In order to perform their job successfully, people who work as Claims Analysts must consistently demonstrate qualities such as integrity, dependability, and stress tolerance.

Below, you'll find a list of qualities typically required of Claims Analysts, ranked by importance:

Integrity
Job requires being honest and ethical.
Dependability
Job requires being reliable, responsible, and dependable, and fulfilling obligations.
Stress Tolerance
Job requires accepting criticism and dealing calmly and effectively with high-stress situations.
Attention to Detail
Job requires being careful about detail and thorough in completing work tasks.
Self-Control
Job requires maintaining composure, keeping emotions in check, controlling anger, and avoiding aggressive behavior, even in very difficult situations.

What education and training do Claims Analysts need?

Many Claims Analysts will have a four-year bachelor's degree, but some do not.

Claims Analysts usually need several years of work-related experience, on-the-job training, and/or vocational training.

Educational degrees among Claims Analysts

  • 1.0% did not complete high school or secondary school
  • 13.9% completed high school or secondary school
  • 23.6% completed some college coursework
  • 11.1% earned a Associate's degree
  • 40.5% earned a Bachelor's degree
  • 7.9% earned a Master's degree
  • 2.0% earned a doctorate or professional degree

Knowledge and expertise required by Claims Analysts

Claims Analysts may benefit from understanding of specialized subject areas, such as customer and personal service, law and government, or administrative knowledge.

The list below shows several areas in which most Claims Analysts might want to build proficiency, ranked by importance.

Customer and Personal Service
Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
Law and Government
Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.
Administrative
Knowledge of administrative and office procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and workplace terminology.
Mathematics
Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.
Administration and Management
Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.

Important Abilities needed by Claims Analysts

Claims Analysts must develop a particular set of abilities to perform their job well. Abilities are individual capacities that influence a person's information processing, sensory perception, motor coordination, and physical strength or endurance. Individuals may naturally have certain abilities without explicit training, but most abilities can be sharpened somewhat through practice.

For example, Claims Analysts need abilities such as oral comprehension, written comprehension, and oral expression in order to perform their job at a high level. The list below shows several important abilities for Claims Analysts, ranked by their relative importance.

Oral Comprehension
The ability to listen to and understand information and ideas presented through spoken words and sentences.
Written Comprehension
The ability to read and understand information and ideas presented in writing.
Oral Expression
The ability to communicate information and ideas in speaking so others will understand.
Deductive Reasoning
The ability to apply general rules to specific problems to produce answers that make sense.
Inductive Reasoning
The ability to combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events).

Critical Skills needed by Claims Analysts

Skills are developed capacities that enable people to function effectively in real-world settings. Unlike abilities, skills are typically easier to build through practice and experience. Skills influence effectiveness in areas such as learning, working with others, design, troubleshooting, and more.

Claims Analysts frequently use skills like reading comprehension, critical thinking, and active listening to perform their job effectively. The list below shows several critical skills for Claims Analysts, ranked by their relative importance.

Reading Comprehension
Understanding written sentences and paragraphs in work-related documents.
Critical Thinking
Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions, or approaches to problems.
Active Listening
Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
Speaking
Talking to others to convey information effectively.
Negotiation
Bringing others together and trying to reconcile differences.

What is the source of this information?

The information provided on this page is adapted from data and descriptions published by the U.S. Department of Labor, Employment and Training Administration under the CC BY 4.0 license. TraitLab has modified some information for ease of use and reading, and the U.S. Department of Labor, Employment, and Training Administration has not approved, endorsed, or tested these modifications.

If you have any questions or suggestions about this information, please send a message.