What Does a Claims Adjuster Do?
A claims adjuster evaluates insurance claims to determine their validity and the appropriate settlement amount. Working on behalf of insurance companies, adjusters investigate claims by gathering facts, reviewing policy documents, inspecting damages, and interviewing all involved parties. Their goal is to ensure that payouts are fair, accurate, and compliant with policy terms.
Claims adjusters play a vital role in balancing customer service with risk management. They handle a wide range of claim types, such as auto accidents, property damage, personal injury, or business liability, depending on the insurer’s focus. Some adjusters work in the field, visiting claim sites in person, while others work from the office or remotely using digital tools.
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Claims Adjuster Core Responsibilities
- Investigate insurance claims by interviewing claimants, witnesses, and professionals (e.g., mechanics, contractors, physicians)
- Review policy terms to determine coverage and limitations
- Inspect property damage or gather documentation (photos, police reports, repair estimates)
- Negotiate settlements with policyholders or third parties
- Coordinate with legal counsel or external investigators when necessary
- Prepare detailed claim reports and recommendations for payment or denial
- Ensure compliance with federal, state, and company-specific regulations
- Provide customer support throughout the claim resolution process
Required Skills and Qualifications
Hard skills
- Knowledge of insurance policies, coverage rules, and claim processes
- Ability to evaluate damage estimates and repair costs
- Familiarity with claims management software (e.g., Xactimate, Guidewire)
- Strong written documentation and reporting skills
- Regulatory compliance and recordkeeping
Soft skills
- Strong attention to detail and analytical thinking
- Conflict resolution and negotiation
- Empathy and professionalism when working with claimants
- Time management and ability to handle multiple claims
- Clear communication and customer service mindset
Educational requirements
- High school diploma or GED required
- Associate’s or bachelor’s degree in business, criminal justice, or related field preferred
Certifications
- Claims Adjuster license required in many states
- Continuing education or state-specific certification may be necessary
Preferred Qualifications
- Previous experience in insurance, investigations, or construction estimating
- Bilingual skills for communicating with diverse client populations
- Certification from industry bodies like the National Association of Independent Insurance Adjusters (NAIIA)
- Specialized experience (e.g., auto, property, workers’ compensation, catastrophe claims)
National Average Salary
Claims adjuster salaries vary by experience, industry, organization size, and geography. Click below to explore salaries by local market.
The average national salary for a Claims Adjuster is:
$55,632
Sample Job Description Templates for Claims Adjusters
Entry-Level Claims Adjuster
Position Overview
An Entry-Level Claims Adjuster supports the investigation and resolution of basic insurance claims, working under the supervision of experienced adjusters. They assist in gathering documentation, communicating with claimants, and helping determine coverage and settlement recommendations.
Responsibilities
- Assist in collecting incident details, policy information, and supporting documents
- Contact claimants and witnesses to obtain initial statements
- Review claims for coverage eligibility based on policy terms
- Support preparation of reports and recommendations for settlement or denial
- Collaborate with senior adjusters and supervisors on complex cases
- Learn to use claims management systems and internal tools
Requirements
Hard skills
- Basic understanding of insurance terms and claims process
- Data entry and report preparation
- Proficiency with standard office software (e.g., Excel, Outlook)
- Strong written communication
Soft skills
- Willingness to learn and follow established procedures
- Customer service orientation
- Time management and organization
- Attention to detail
Education
- High school diploma or GED required
- Associate’s or bachelor’s degree preferred
Certifications
- Claims Adjuster license (may be required based on state)
Senior Claims Adjuster
Position Overview
A Senior Claims Adjuster handles complex, high-value, or disputed insurance claims. They lead investigations, negotiate settlements, and often mentor junior staff while ensuring accuracy and compliance in claim resolutions.
Responsibilities
- Independently manage complex or high-stakes insurance claims
- Investigate losses by analyzing documentation and conducting interviews
- Evaluate repair estimates, medical reports, and legal implications
- Negotiate settlements with claimants, attorneys, or other insurers
- Mentor junior adjusters and review their claims for accuracy
- Prepare detailed reports and coordinate with legal teams as needed
Requirements
Hard skills
- Advanced knowledge of insurance policies, regulations, and procedures
- Strong negotiation and conflict resolution skills
- Proficiency with claims systems (e.g., Guidewire, Xactimate)
- Report writing and litigation preparation
Soft skills
- Leadership and mentoring capabilities
- Analytical and strategic thinking
- High-level decision-making
- Excellent communication with diverse stakeholders
Education
- Associate’s or bachelor’s degree in business, insurance, or related field
- Continuing education preferred
Certifications
- Active Claims Adjuster license required
- Advanced certifications (e.g., AIC, CPCU) preferred
Field Claims Adjuster
Position Overview
A Field Claims Adjuster conducts on-site investigations to assess damage or loss. They inspect properties, vehicles, or incident scenes and work directly with claimants, often in emergency or high-pressure environments.
Responsibilities
- Travel to claim locations to inspect physical damages
- Conduct in-person interviews with claimants and witnesses
- Document site conditions using photos, sketches, or drone footage
- Estimate repair costs and prepare field reports
- Coordinate with contractors, appraisers, and law enforcement
- Recommend settlements based on firsthand evaluation
Requirements
Hard skills
- Physical inspection techniques
- Use of mobile inspection tools or estimating software
- Driving and route planning for field visits
- Documentation and photography skills
Soft skills
- Comfort working independently in varied environments
- Empathy and professionalism during in-person interactions
- Adaptability in unpredictable settings
- Strong observational and analytical skills
Education
- High school diploma required; associate’s or bachelor’s preferred
Certifications
- Claims Adjuster license required
- Valid driver’s license and reliable transportation
Desk Claims Adjuster
Position Overview
A Desk Claims Adjuster manages insurance claims remotely, using documentation, digital tools, and phone/email communication to evaluate and settle claims. They often handle a high volume of routine or moderately complex cases.
Responsibilities
- Review claim files, policy coverage, and supporting documentation
- Communicate with claimants, agents, and service providers via phone/email
- Analyze photos, estimates, and records to determine liability
- Process payments, denials, or escalations through digital platforms
- Maintain accurate documentation and ensure regulatory compliance
Requirements
Hard skills
- Proficiency in claims software (e.g., Guidewire, Symbility)
- Digital claims review and data analysis
- Strong typing and report-writing abilities
- Remote communication tools (e.g., Zoom, Slack, email platforms)
Soft skills
- Focus and efficiency in a fast-paced digital environment
- Written communication and follow-up discipline
- Customer service via phone and email
- Task prioritization and multi-claim tracking
Education
- Associate’s or bachelor’s degree preferred
Certifications
- Claims Adjuster license required depending on state or insurer