Claims Adjusters, Examiners, and Investigators
SOC Code: 13-1031 Job Zone 4: Considerable Preparation Needed
Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confer with legal counsel on claims requiring litigation. May also settle insurance claims.
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Prevailing Wage Levels (National)
DOL/OFLC prevailing wage thresholds for Claims Adjusters, Examiners, and Investigators. Hourly rates x 2,080 = annual.
FY2027 Weighted Lottery Impact
| Level | Lottery Entries | Est. Selection Rate |
|---|---|---|
| Level I (Entry) | 1 entry | ~16% |
| Level II (Qualified) | 2 entries | ~31% |
| Level III (Experienced) | 3 entries | ~45% |
| Level IV (Expert) | 4 entries | ~61% |
Prevailing Wages by Metro Area
| Metro Area | Level I | Level II | Level III | Level IV |
|---|---|---|---|---|
| Prescott Valley-Prescott, AZ | $45,947 | $79,830 | $113,734 | $147,618 |
| San Jose-Sunnyvale-Santa Clara, CA | $74,818 | $92,955 | $111,093 | $129,230 |
| Bridgeport-Stamford-Danbury, CT | $70,054 | $88,691 | $107,307 | $125,944 |
| Flagstaff, AZ | $43,846 | $70,450 | $97,053 | $123,656 |
| Lake Havasu City-Kingman, AZ | $43,846 | $70,450 | $97,053 | $123,656 |
| Salinas, CA | $75,878 | $89,627 | $103,355 | $117,104 |
| San Francisco-Oakland-Fremont, CA | $74,027 | $88,192 | $102,357 | $116,522 |
| Merced, CA | $69,306 | $84,531 | $99,757 | $114,982 |
| Norwich-New London-Willimantic, CT | $71,885 | $85,301 | $98,717 | $112,133 |
| Hartford-West Hartford-East Hartford, CT | $63,794 | $79,539 | $95,306 | $111,051 |
Key Skills
| Skill | Importance | Level |
|---|---|---|
| Reading Comprehension | 4.1 | |
| Active Listening | 4.0 | |
| Critical Thinking | 4.0 | |
| Speaking | 3.9 | |
| Judgment and Decision Making | 3.8 | |
| Writing | 3.6 | |
| Complex Problem Solving | 3.5 | |
| Social Perceptiveness | 3.4 | |
| Monitoring | 3.4 | |
| Active Learning | 3.2 |
Knowledge Areas
| Knowledge | Importance |
|---|---|
| Customer and Personal Service | 4.7 |
| English Language | 4.4 |
| Administrative | 3.8 |
| Mathematics | 3.7 |
| Computers and Electronics | 3.4 |
| Law and Government | 3.3 |
| Administration and Management | 3.1 |
| Economics and Accounting | 3.0 |
Education Requirements
| Education Level | % of Workers |
|---|---|
| Bachelor's degree | 55.8% |
| High school diploma | 13.1% |
| Associate's degree | 12.0% |
| Post-secondary certificate | 11.9% |
| Post-first professional | 4.0% |
| Some college | 2.6% |
Typical 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.
- Investigate and assess damage to property and create or review property damage estimates.
- Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
- 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.
Technology Skills
Green = Hot Technology in demand
Apple Safari Microsoft Access Microsoft Excel Microsoft Office software Microsoft Outlook Microsoft PowerPoint Microsoft Word Mozilla Firefox Zoom 4n6xprt Systems StiffCalcs ADP software ARSoftware WinSMAC Agency Management Systems AMS 360 AutoClaims Direct DirectLink Automatic Data Processing Autosource
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