Claims Adjusters, Examiners, and Investigatorsresume guide.
Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. A strong Claims Adjusters, Examiners, and Investigators resume shows reading comprehension, active listening and critical thinking, and names the tools you have worked with, such as Microsoft Access, Mozilla Firefox and Apple Safari.
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- 1Put your authority and closing speed in numbers.The guide lists "Pay and process claims within designated authority level." Your dollar limit and how fast you close show a manager what desk you can take over, and carriers watch cycle time closely.
- 2Show the storms you worked.Big catastrophe losses have hit year after year, so carriers want adjusters who can deploy and still close clean files. Claims count, weeks and reopen rate prove it.
- 3Show where your judgment mattered.Insurers now use software to flag possible fraud, and openings for experienced adjusters have held up better than entry-level ones. This bullet shows the human work: "investigate questionable claims" from the guide, with dollars saved.
- 4Name the records you reviewed."Review police reports, medical treatment records, medical bills, or physical property damage" is a core task here. Naming those records, then the result, reads as real liability work.
- 5Give your license its full name, state and status.Rules differ by state, and Wisconsin adjusters often hold a designated home state license from another state. Write the license type, the issuing department and that it is active, and spell out AIC instead of using the letters alone.
- 6Keep education to one line.Most people in this job have a bachelor's degree. One line with the degree and field is enough.
Sample resume. The candidate is fictional; the layout and templates are real.
01Also called
O*NET02Skills employers expect
O*NETImportance is how much the skill matters to the job; level is how much of it the job demands. Both are worth naming on the resume, in this order.
| Skill | Importance | Level |
|---|---|---|
| Reading Comprehension | Very high | Advanced |
| Active Listening | Very high | Advanced |
| Critical Thinking | Very high | Advanced |
| Speaking | High | Advanced |
| Judgment and Decision Making | High | Intermediate |
| Writing | High | Intermediate |
| Complex Problem Solving | High | Intermediate |
| Monitoring | High | Intermediate |
| Social Perceptiveness | High | Intermediate |
| Active Learning | High | Intermediate |
03Knowledge areas
O*NET- Customer and Personal Service
- English Language
- Administrative
- Mathematics
- Computers and Electronics
- Law and Government
- Administration and Management
- Economics and Accounting
- Education and Training
- Psychology
04Common responsibilities
O*NETOrdered by importance. Each one is a bullet waiting for a result and a number.
- Examine claims forms and other records to determine insurance coverage.
- Analyze information gathered by investigation and report findings and recommendations.
- Pay and process claims within designated authority level.
- 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.
- 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.
- 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.
- Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
05Software and tools
O*NET73 tools across 21 categories. The six largest categories are below; Hot marks a hot technology, In demand a tool employers ask for most often.
- Document management system software
- Hyland OnBase Enterprise Content Management
- Agency Management Systems AMS 360
- AutoClaims Direct DirectLink
- Automatic Data Processing Autosource
- Automatic Data Processing Claims Manager & Dispatch
- BCCORP Burkitt W5
- BCCORP W5 for Adjusters
- Bramerhill ClaimsTech
- Bridium Claims 3
- Brightwork Alyce Claims Systems
- Captiva InputAccel
- Castek Insure3 Claims
- CCC Pathways Image Management Solution
- CCC TL2000 Solution
- CGI INSideOUT
- Clear Technology Tranzax
- Covansys ClaimConnect
- Datanex ClaimTrac
- InSystems Calligo Document Management System
- Axonwave Fraud and Abuse Management System
- CCC GuidePost Decision Support
- CSC Fault Evaluator
- Fair Isaac SmartAdvisor
- First Notice Systems ClaimCapture
- Hummingbird Legal Bill Review
- IBM Fraud and Abuse Management System
- ISO ClaimSearch
- ISO NetMap for Claims
- LexisNexis RiskWise
- StrataCare StrataWare eReview
- 4n6xprt Systems StiffCalcs
- ARSoftware WinSMAC
- CAD Zone Insurance
- MapScenes Evidence Recorder
- MapScenes Pro
- PhotoModeler
- Visual Statement Investigator Suite
- Automatic Data Processing Estimating
- CSC Colossus
- Property damage, bodily injury, and liability estimation software
- QwikQuote software
- Simsol for Adjusters
- Turtle Creek Software Goldenseal Architect
- Microsoft AccessHotIn demand
- Xactware XactimateIn demand
- Claims processing administration and management software
- Fair Isaac Claims Advisor
- Tropics Claims Reserve Management
- Injury Sciences EDR InSight
- Insurance claims fraud detection software
- Magnify Predictive Targeting System
- Medical procedure coding software
- Healthcare common procedure coding system HCPCS
- Medical condition coding software
- CCC EZNet electronic communications network
- CSC Automated Work Distributor AWD
- ADP software
- CCC Pathways Appraisal Quality Solution
- Mozilla FirefoxHotIn demand
- Apple SafariHotIn demand
- Microsoft Office softwareHotIn demand
- Business software applicationsIn demand
- Bill review software
- Corporate Systems ClaimsPro
- Microsoft OutlookHotIn demand
- CGI-AMS BureauLink Enterprise
- Computerized voice stress analyzer CVSA software
- Microsoft PowerPointHotIn demand
- Microsoft ExcelHotIn demand
- ZoomHotIn demand
- Microsoft WordHotIn demand
06Education and preparation
O*NET07Putting it on your resume
ResumeXRays guidanceLead with what you built. For a Job Zone 4 role, hiring managers and parsers both look for outcomes before credentials. Put two or three results at the top of each job entry, with the scale or effect stated plainly.
Name the tools exactly. This occupation is heavy on named software. A skills section that says "Microsoft Access, Mozilla Firefox, Apple Safari, Microsoft Office software" matches more job descriptions than a general phrase. Use the spelling employers use.
Show active listening and critical thinking, not just reading comprehension. Active listening and critical thinking rank close to reading comprehension for this occupation. One bullet per role that shows a decision, a tradeoff or a result covers them.
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