CAREER GUIDE FOR INSURANCE CLAIMS ADJUSTERSOC Code: 13-1031.02 Pay Band(s): 4 and 5 (Salary Structure) Standard Occupational Description: Investigate, analyze, and determine the extent of insurance company's liability concerning personal, casualty, or property loss or damages, and attempt to effect settlement with claimants. Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Calculate benefit payments and approve payment of claims within a certain monetary limit. Insurance Claims Adjuster positions in the Commonwealth are assigned to the following Roles in the Land Acquisition and Property Management Career Group: Land Acquisition and Property Management Agent II Land Acquisition and Property Management Agent III While Insurance Claims Adjusters within the Commonwealth are all located within the Land Acquisition and Property Management Career Group, individuals may want to pursue other opportunities within the Commonwealth depending upon individual training, education, knowledge, skills, abilities, and interests. Other Career Group(s) that may be of interest are: SKILLS, KNOWLEDGE, ABILITIES AND TASKS(Technical and Functional Expertise) Skills Note: The technical and functional skills listed below are based on general occupational qualifications for Insurance Claims Adjusters commonly recognized by most employers. Typically, you will not be required to have all of the skills listed to be a successful performer. Recruitment and selection standards for an individual state job must be based on the specific knowledge, skills, and abilities for that job as indicated in the job announcement and job description in the Employee Work Profile.
KnowledgeNote: The technical and functional knowledge statements listed below are based on general occupational qualifications for Insurance Claims Adjusters commonly recognized by most employers. Typically, you will not be required to have all of the knowledge listed to be a successful performer. Recruitment and selection standards for an individual state job must be based on the specific knowledge, skills, and abilities for that job as indicated in the job announcement and job description in the Employee Work Profile. The Knowledge of:
Abilities Note: The technical and functional abilities listed below are based on general occupational qualifications for Insurance Claims Adjusters commonly recognized by most employers. Typically, you will not be required to have all of the abilities listed to be a successful performer. Recruitment and selection standards for an individual state job must be based on the specific knowledge, skills, and abilities for that job as indicated in the job announcement and job description in the Employee Work Profile. The Ability to:
Tasks Note: The following is a list of sample tasks typically performed by Insurance Claims Adjusters. Employees in this occupation will not necessarily perform all of the tasks listed. Tasks
INTERESTED?Like people, occupations have traits or characteristics. These characteristics give important clues about the nature of the work and work environment, and give you an opportunity to match your own personal interests to a specific occupation. When you choose a job in an occupation that matches your own interests you have taken an important step in planning a successful and rewarding career. The occupation of Insurance Claims Adjuster has characteristics as described below: Enterprising — 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. Investigative — Investigative occupations frequently involve working with ideas, and require an extensive amount of thinking. These occupations can involve searching for facts and figuring out problems mentally. Social — Social occupations frequently involve working with, communicating with, and teaching people. These occupations often involve helping or providing service to others. Conventional — 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. LICENSURE, REGISTRATION, OR CERTIFICATION REQUIREMENTSGenerally this is not required for Insurance Claims Adjuster positions in state government. In some States, claims adjusters employed by insurance companies can work under the company license and need not become licensed themselves. Separate or additional requirements may apply for public adjusters. For example, some States require public adjusters to file a surety bond. In addition, many adjusters and examiners choose to earn professional certifications and designations for independent recognition of their professional expertise. A valid Virginia driver's license may be required. The Insurance Institute of America http://www.aicpcu.org certifies those working as insurance claims adjusters in the following areas: Associate in Claims, Associate in Insurance Services, and Associate in Regulation and Compliance. EDUCATIONAL, TRAINING, AND LEARNING OPPORTUNITIESThe Department of Labor provides the following information: Adjusters plan and schedule the work required to process an insurance claim. They investigate claims by interviewing the claimant and witnesses, consulting police and hospital records, and inspecting property damage to determine the extent of the company's liability. Adjusters may also consult with other professionals, such as accountants, architects, construction workers, engineers, lawyers, and physicians, who can offer a more expert evaluation of a claim. The information gathered, including photographs and written or taped statements, is set down in a report that is then used to evaluate a claim. When the policyholder's claim is legitimate, the claims adjuster negotiates with the claimant and settles the claim. When claims are contested, adjusters will work with attorneys and expert witnesses to defend the insurer's position. Training and entry requirements vary widely for claims adjusters. Although many in these occupations do not have a college degree, most companies prefer to hire college graduates. A legal background can be beneficial to someone handling workers' compensation and product liability cases. A medical background is useful for those examiners working on medical and life insurance claims. Continuing education (CE) in claims is very important for claims adjusters because new Federal and State laws and court decisions frequently affect how claims are handled or who is covered by insurance policies. Beginning claims adjusters work on small claims under the supervision of an experienced worker. As they learn more about claims investigation and settlement, they are assigned larger, more complex claims. Trainees are promoted as they demonstrate competence in handling assignments and progress in their coursework. Employees who demonstrate competence in claims work or administrative skills may be promoted to more responsible managerial or administrative jobs. COMMONWEALTH COMPETENCIESCompetencies are a set of identified behaviors, knowledge, skills, and abilities that directly and positively impact the success of employees and the organization. Competencies can be observed and measured. When consistently demonstrated, competencies make employees particularly effective in their work. Competencies help lay out a road map to career success. You can use the Commonwealth Competencies to help improve your individual performance by adopting behaviors that make high performing employees successful in their jobs. In this way, you can use the Commonwealth Competencies for your further professional development. The Commonwealth Competencies are:
The above competencies may be applied to employees throughout the Commonwealth of Virginia. They can be rank-ordered by agencies and hiring managers to represent the needs of a specific job. The rank ordering will change depending upon the occupation, an organization's priorities, the actual job requirements, and the supervisor's preferences. Career success is both about what you do (applying your technical knowledge, skills, and ability) and how you do it (the consistent behaviors you demonstrate and choose to use) while interacting and communicating with others. Hopefully, by studying the Commonwealth competencies, identifying your developmental opportunities, and working to refine your own competence, you can take charge of your career! For additional information about the Commonwealth Competencies go to: http://jobs.state.va.us/cc_planningctr.htm. For the competencies, we first list the competencies and then define each. Finally, we list competency indicators; to describe what successful performance looks like. COMMONWEALTH CAREER PATHCareer opportunities in the Commonwealth are not limited to moving “up” to the next highest role and pay band, changing positions, or to becoming a supervisor. That's because most roles describe a broad group of occupationally related positions that perform a range of work that requires increased knowledge and skills. For that reason, Commonwealth roles describe the career paths within the same or higher-level role for the same or different Career Group. The broad salary range and the Commonwealth's pay practices provide flexibility in recognizing career development and advancement. (Salary Structure) For example: Insurance Claims Adjuster
Sample Career Path Land Acquisition and Property Management Agent II The Land Acquisition and Property Management Agent II role provides career tracks for Insurance Claims Adjusters whose responsibilities range from entry- to journey-level. Land Acquisition and Property Management Agent III The Land Acquisition and Property Management Agent III role provides career tracks for insurance claims adjusters who perform, lead, and/or supervise insurance and property management activities. Land Acquisition and Property Manager I The Land Acquisition and Property Manager I role provides career tracks for first-level managers who manage the work of staff engaged in equipment and facilities management Program and project planning and prioritization are typical responsibilities of this role. Land Acquisition and Property Manager II The Land Acquisition and Property Manager II role provides career tracks for senior-level managers who exercise broad discretion in developing, implementing, and/or administering multiple, regional, or statewide programs. ADDITIONAL OCCUPATIONAL INFORMATION CAN BE FOUND AT:O*NET (Occupational Information Network) http://online.onetcenter.org/gen_search_page Virginia Employment Commission http://www.alex.vec.state.va.us/ Career One Stop Virginia Career Resource Network Insurance Institute of America International Claim Association
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