Claim Inspector

Claims inspector / scrap handlers review claims to verify both the claimant and claim adjuster followed due process during the investigation and reporting phase of a case. Claims examiners ensure compliance and approve or deny claims while assisting adjusters when needed. They diligently review reports to ensure that no errors have been made in the appraisal process and determine whether payout amounts are reasonable. They approve, reject, or refer a claim to a specialist and meet with claimants with dispute settlements.

Claims inspector ensure cases comply with regulatory standards, company policy, and guidelines and provide assistance to claim adjusters to manage caseloads. Claims examiners consult with specialists including engineers and assist attorneys and other specialists when defending the company against contested claims. They contribute to the final decision coverage of losses. Claims inspector need a high school diploma for an entry-level position, and a bachelor's degree in finance or related fields is preferred.

**responsibilities for Claims Inspector jobs**
- Efficiently investigate, evaluate, and manage all type of claims.
- Communicate with claimants, providers and vendors regarding claims issues.
- Maintain a suspense system to ensure regular review of case files.
- Prepare timely and appropriate file reviews, per departmental guidelines.
- Establish and maintain appropriate reserves in accordance with department policies and procedures.
- Input claims into the system for appropriate tracking and processing.
- Provide support, coaching and mentoring to other team members, as needed.
- Interact directly with policyholders on claim updates and resolution strategies.
- Direct and manage legal counsel to ensure timely and cost-effective litigation.
- Perform work that is varied and that may be somewhat difficult in character, but usually involves limited responsibility.
- Monitor case files daily to determine if reserves are set accurately and adjust within authority.
- Closely monitor day to day operations of self and team to ensure utilization and minimize errors.
- Accountable for reviewing adjudication software system's claim and line item edits to decide whether to pay claim/line item(s).
- Develop some level of communication with client claims managers to address issues,
- Participate in meetings and project activities outside of the primary location at locations.

**typical qualifications for Claims inspector jobs?**
- Bachelor's Degree in business or training in insurance practices and equivalent experience.
- Sound negotiation and problem solving capabilities.
- Proven record of attention to detail, time management, and leadership abilities..
- Is a critical thinker and able to deploy writing protocols for correspondence including client EOB statements.
- Comfortable multitasking.