Average Salary for Jobs with Claim Investigation Skills

Conducts the medical review activities needed to resolve and process clinical appeals and claims. Reviews applicable medical records and assesses clinical data to investigate and resolve disputes over the medical necessity for services, approvals, pre-certifications, or other cases. Understands and interprets applicable medical terminology, clinical procedures, regulations and policies. Documents ... View job details

Denies, settles, or authorizes payments to routine property/casualty claims based on coverage, appraisal, and verifiable damage. Corresponds with policyholders, claimants, witnesses, attorneys, etc. to gather important information to support contested insurance claims. Makes recommendations for settlement of routine property/casualty claims based on coverage, appraisal, and verifiable damage. Prep... View job details

Denies, settles, or authorizes payments to routine property/casualty claims based on coverage, appraisal, and verifiable damage. Responsible for corresponding with policyholders, claimants, witnesses, attorneys, etc. to gather important information to support contested claims. Prepares reports of investigation findings. May conduct field evaluations to inspect and document damage or loss. May requ... View job details

Denies, settles, or authorizes payments to more complex property/casualty claims based on coverage, appraisal, and verifiable damage. Examines claim forms and other records to determine coverage. Responsible for corresponding with policyholders, claimants, witnesses, attorneys, etc. to gather important information to support contested. Conducts field investigations to inspect and document damage o... View job details

Reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Determines settlement according to organiz... View job details