Standard Occupational Classification (SOC): Claims Adjusters, Examiners, and Investigators

Claims adjusters, examiners, and investigators in healthcare work to evaluate and settle insurance claims related to healthcare services and treatments. They may work for insurance companies, hospitals, clinics, or other healthcare organizations.

Claims adjusters, examiners, and investigators in healthcare may be responsible for reviewing and evaluating insurance claims to determine the amount of coverage that is available and the extent of the damages or injuries covered by the policy. They may also investigate claims to ensure that they are valid and that the information provided is accurate.

To become a claims adjuster, examiner, or investigator in healthcare, individuals typically need to have a bachelor’s degree in a related field, such as business or healthcare administration, and may be required to pass a licensing exam. Some positions may also require experience in the field or specialized training in insurance or healthcare.