Claim Adjusters, Examiners, and Investigator Resume Example
Professional resume template and tips for Claim Adjusters, Examiners, and Investigator positions
Are you exploring a career as a claim adjuster, examiner, or investigator? This role is central to the insurance industry, where you will evaluate claims, analyze investigation data, and make critical settlement decisions. Success requires a blend of analytical skills like critical thinking and systems analysis, proficiency with tools like Xactimate and AMS 360, and strong interpersonal abilities for negotiation and customer service. This guide provides a clear overview of the daily responsibilities, essential technical and soft skills, and key knowledge areas for the profession. We’ll also share practical tips to help you build a compelling resume that showcases your qualifications for this detail-oriented field. Start crafting your application with confidence using Mokaru’s resume tools.
NATHAN ALLEN
Professional Summary
Claim Adjusters, Examiners, and Investigator with 8+ years experience specializing in commercial property and casualty claims for a national insurer. Reduced average claim cycle time by 22% through meticulous file analysis and Microsoft Access database management. Proficient in claim investigation, coverage determination, and processing within designated authority.
Skills
Experience
- Led a complex fraud investigation using critical thinking and Microsoft Access data analysis, recovering $2.1M and reducing fraudulent claims by 18%
- Developed and delivered a training program via Microsoft PowerPoint on claims adjudication best practices, improving team accuracy by 15%
- Spearheaded a strategic review of high-value claims processes using judgment and decision making, cutting average settlement time by 25%
- Owned the investigation and settlement of 50+ commercial property claims monthly, utilizing active listening to negotiate fair outcomes efficiently
- Collaborated with legal and underwriting teams to analyze complex coverage issues, resolving 30+ backlogged cases through detailed written reports
- Implemented a new Excel tracking system for subrogation cases, improving recovery rates by 12% and enhancing team monitoring capabilities
- Supported senior adjusters by meticulously examining 20+ claims forms daily in Apple Safari, ensuring accurate initial coverage determinations
- Executed data entry and preliminary analysis in Microsoft Excel for 100+ auto claims, assisting in the identification of settlement trends
- Learned and applied company procedures for processing claims within authority, developing strong writing skills for clear case documentation
Education
Certificates
- Associate in Claims
- Certified Fraud Examiner
- Certified Insurance Examiner
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What does a Claim Adjusters, Examiners, and Investigator do?
A Claim Adjusters, Examiners, and Investigator performs various tasks on a daily basis. Here are the core responsibilities you can expect in this role:
- 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.
What skills do you need as a Claim Adjusters, Examiners, and Investigator?
Employers hiring for Claim Adjusters, Examiners, and Investigator positions look for candidates with a strong combination of technical and soft skills. Here are the most important skills to highlight on your resume:
What knowledge areas are important for a Claim Adjusters, Examiners, and Investigator?
Beyond skills and tools, employers value candidates with deep knowledge in these areas. Consider highlighting relevant coursework, certifications, or experience:
How do I write a great Claim Adjusters, Examiners, and Investigator resume?
Creating an effective Claim Adjusters, Examiners, and Investigator resume requires focusing on what employers in the Finance & Accounting sector value most.
Use relevant keywords
ATS systems scan for specific terms. Include these keywords naturally throughout your resume:
Quantify your impact
When describing how you "examine claims forms and other records to determine insurance coverage", include metrics like percentages, team sizes, budgets, or project scope to demonstrate real results.
Showcase technical proficiency
Highlight hands-on experience with Microsoft Office software, Microsoft Excel, Microsoft Outlook and any customer and personal service certifications that validate your expertise.
Match the experience level
For Claim Adjusters, Examiners, and Investigator roles, employers typically expect usually requires a 4-year bachelor's degree. Highlight matching qualifications prominently at the top of your resume.
Example bullet points
Here are some strong bullet points you could adapt for your Claim Adjusters, Examiners, and Investigator resume:
- Led a complex fraud investigation using critical thinking and Microsoft Access data analysis, recovering $2.1M and reducing fraudulent claims by 18%
- Developed and delivered a training program via Microsoft PowerPoint on claims adjudication best practices, improving team accuracy by 15%
- Spearheaded a strategic review of high-value claims processes using judgment and decision making, cutting average settlement time by 25%
How to use AI to improve your Claim Adjusters, Examiners, and Investigator resume
AI tools like ChatGPT can be incredibly helpful when crafting your Claim Adjusters, Examiners, and Investigator resume. They can help you brainstorm achievements, rephrase bullet points for impact, identify missing keywords, and tailor your content to specific job descriptions.
However, AI is not perfect. Always proofread the output carefully. AI can sometimes make factual errors, use generic language, or miss the nuances of your specific experience. Think of AI as a helpful assistant, not a replacement for your own judgment.
AI Resume Prompt
You are a senior recruiter with 15+ years of experience in technical hiring and resume optimization. You have reviewed thousands of resumes for Claim Adjusters, Examiners, and Investigator positions and know exactly what hiring managers and ATS systems look for.
Your task:
Analyze my resume for a Claim Adjusters, Examiners, and Investigator position and provide concrete, actionable feedback to maximize my chances.
Job description:
[paste the job description here]
Provide feedback on the following:
- Match analysis: Which requirements from the job description ARE and ARE NOT reflected in my resume?
- Quantification: Which bullet points lack concrete numbers/metrics? Provide examples of how I can rewrite them.
- Keywords: Which technical terms from the job description (such as Microsoft Office software, Microsoft Excel, Microsoft Outlook, etc.) are missing or could be more prominent?
- Impact statements: Rewrite my 3 weakest bullet points using the STAR format (Situation, Task, Action, Result)
- ATS optimization: What adjustments will increase my score in Applicant Tracking Systems?
- Priorities: Give me a top-5 of changes that will make the biggest difference, ranked by impact.
Be direct and critical - I want honest feedback, not compliments.
Why use Mokaru instead? At Mokaru, we have invested extensive research into our AI prompts and continuously update them based on recruiter feedback and ATS testing. Our AI resume builder handles the complexity for you: optimizing for ATS systems, matching job descriptions, and ensuring professional formatting, so you can focus on landing interviews.
Claims Adjuster Resume Example
Looking for a Claims Adjuster resume instead? The skills and experience are very similar to a Claim Adjusters, Examiners, and Investigator. Here is an example you can use as inspiration:
ERIC MORGAN
Summary
Claim Adjusters, Examiners, and Investigator with 8+ years experience specializing in commercial property and casualty claims for a national insurer. Reduced average claim cycle time by 22% through meticulous file analysis and Microsoft Access database management. Proficient in claim investigation, coverage determination, and processing within designated authority.
Skills
Experience
- Led a complex fraud investigation using critical thinking and Microsoft Access data analysis, recovering $2.1M and reducing fraudulent claims by 18%
- Developed and delivered a training program via Microsoft PowerPoint on claims adjudication best practices, improving team accuracy by 15%
- Spearheaded a strategic review of high-value claims processes using judgment and decision making, cutting average settlement time by 25%
- Owned the investigation and settlement of 50+ commercial property claims monthly, utilizing active listening to negotiate fair outcomes efficiently
- Collaborated with legal and underwriting teams to analyze complex coverage issues, resolving 30+ backlogged cases through detailed written reports
- Implemented a new Excel tracking system for subrogation cases, improving recovery rates by 12% and enhancing team monitoring capabilities
- Supported senior adjusters by meticulously examining 20+ claims forms daily in Apple Safari, ensuring accurate initial coverage determinations
- Executed data entry and preliminary analysis in Microsoft Excel for 100+ auto claims, assisting in the identification of settlement trends
- Learned and applied company procedures for processing claims within authority, developing strong writing skills for clear case documentation
Education
Certifications
- Associate in Claims
- Certified Fraud Examiner
- Certified Insurance Examiner
Build Your Claims Adjuster Resume
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Frequently Asked Questions
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