Examiner Job Description
Examiner Duties & Responsibilities
To write an effective examiner job description, begin by listing detailed duties, responsibilities and expectations. We have included examiner job description templates that you can modify and use.
Sample responsibilities for this position include:
Examiner Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Examiner
List any licenses or certifications required by the position: NDE, III, R3, ICC, SCLA, AIC, CPCU, CISSP, CISA, CFC
Education for Examiner
Typically a job would require a certain level of education.
Employers hiring for the examiner job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Collage Degree in Education, Accounting, Finance, Business, Economics, Business/Administration, Department of Education, Military, Law, Auditing
Skills for Examiner
Desired skills for examiner include:
Desired experience for examiner includes:
Examiner Examples
Examiner Job Description
- Ensures control and compliance regulations are followed
- Advise prospective and current applicants
- Handles client complaints and regulatory inquiries
- Routinely interacts with Associate Compliance Directors, Regional Compliance Managers, Financial Advisors, Branch Operation Managers, Branch Managers, Sales Management, Legal Department, Regulators, various product and operational areas of the firm
- Calculates the benefit amount and ensures claims are not being overpaid or underpaid according to the provisions within the specific insurance certificate/policy form that describes the terms and conditions of the applicable coverage
- Provides training to new hires in the examiner position and serves daily in a mentor capacity
- Assists claimants or financial institutions via phone to answer questions, and documents such within the claim file
- Maintains carrier guidance and administrative files, required logs to comply with carrier requirements, reviews and evaluates instructions provided by carriers and assists management with proper implementation
- Completes request for refund form and submits to Premium Processing, verifies monthly outstanding loan balances for active and inactive financial institutions, and ensures that open accounts loan balances are verified every 6 months and closed accounts are verified each month
- Interprets Oregon Revised Statutes, Chapter 147, Oregon Administrative Rules and Oregon Criminal Code
- Have familiarity with ATTAC, CIDNE, WEAT, WTI Lexicon and Community of Interest databases and portals
- Comparison of evidence from victims, scenes, or instruments of incidents to evidence from suspects
- Coursework in Biochemistry, Genetics, Molecular Biology and Statistics desired
- Four years of progressive clerical or administrative service work experience which includes one year of experience working with admissions processes and programs
- Must have Multi-State Title Examining experience, preferably in the midwest or north east regions of the country
- Commercial title experience, preferred
Examiner Job Description
- Commodity focus is the Agri, Metal, Energy sector and direct interaction with FO team leaders, relationship managers, risk department, agency bank, participating bank and 3rd party collateral examiners
- Keep current on regulatory trends through internal and external training
- 50%-75% overnight travel is expected
- Manage the monthly roster process that includes mailing blank rosters to employers for completion, recording the hours reported for each participant by the respective employer, filing completed rosters, and performing a periodic audit of the roster files
- Respond to participant, employer and union requests both verbally (over the phone) and in writing
- Process a variety of transactions to include retiree/beneficiary benefit estimates and payments, benefit recalculations, and miscellaneous transactions
- Review incoming benefit paperwork and documentation for “good order”
- Validate and update Plan participant records
- Collaborate with peers, business partners, and on occasion the NIGPP’s other service providers
- Identify procedures requiring pricing and transfer to EDI Claims Coordinator
- General knowledge of medical claims adjudication
- 3-5 years experience, with minimum 3 years of asset based lending field examination experience
- Must be able to use a keyboard to enter data
- At least 5 years of experience in the search and/or exam field is required
- Must be able to excel in high demand environment
- Must be able to move (push/pull) up to 50 lbs
Examiner Job Description
- Responsible for accurate/timely daily review of Long Term Care claims and policy provisions to determine appropriate claim eligibility assessments for payment or denial up to authority limit of $5,000
- Responsible for accurate/timely determination of additional benefits applicable under policy provisions such as Wavier of Premium, Inflation Protection Options, Guaranteed Purchase Options, and other applicable rider/policy benefits
- Responsible for timely request and follow-up request of any/all required additional information, medical records/notes, appropriate forms/documents, statements and/or certificates needed for proper claim adjudication
- Respond accurately, timely and professionally to all oral and written external and/or internal correspondences received from stakeholders in regard to benefits, eligibility, claim payments, denials and/or explanation of benefits
- Responsible for any on-going LTC claim/case management and recertification of claim benefits
- Responsible for Waiver of Premium (WOP) process
- Maintain working knowledge and proficiency in company claims, administrative and imaging software systems such as INSPRO and Microsoft applications
- Interact professionally with other business units to gather and analyze data needed to properly adjudicate claims and documentation of claims files
- Manages an AR portfolio
- Negotiates, implements and documents payment solutions with customers
- Must have successfully completed the IFIC Mutual Fund and the IFIC Branch Manager exams OR has obtained equivalent experience, training or education required to perform audits under MFDA rules
- Ability to be firm working with large corporations
- Ability to work with Department of Justice/Lawyers & Liquidators
- Minimum of 2-3 years claims experience needed
- Prefer experience working in a Production and Quality environment
- CPT Code/Medical coding experience preferred
Examiner Job Description
- B2C4.2.1 Refer to 3rd Party Collection
- B2C4.2.3 Agree Settlement/Payment Plan
- B2C4.2.5 Process Write Off
- D4B2C7.2.1 Produce Ad-Hoc Report
- B2C8.1.1 Archive Documents
- B2C8.2.1 Retrieve Archived Document
- B2C8.3.1 Destroy Archived Document
- Utilize Technical expertise and experience to drive financial savings (lower cost repairs and reduced product buyouts/replacements)
- Compile daily reports (productivity & costs savings) and maintain accurate and thorough documentation
- Validate repair estimates, and when necessary, challenge Servicer repair estimates
- Knowledge of coordination of benefits principles and terminology
- Adjusts complex property claims
- Servers as a resource to less experienced team members on escalated issues of a unique nature
- Contribute to business goals, performance metrics, and effectively uses tools & technology
- Supports workload surges and/or Catastrophe perations as needed to include working significant overtime during designated CATs
- Bachelor's degree or 4 years relevant/equivalent work experience
Examiner Job Description
- Assess repair escalation history to determine best “go-forward” decision (expedite repair solution or replace/buyout product)
- Work closely with management to identify specific manufacturer repair issues which have a large financial impact (quality related issues that result in large volumes of repair)
- Identify rapid repair solutions to avoid costly buyout due to time-in-service
- Utilize historical data to identify specific patterns of Servicer behavior that drive unnecessary costs or negatively impact customer experience
- Provide technical information, training and support to other departments as directed by Management
- Responsible for working with Lead to perform operational reviews based upon risk, client, regulatory and internal requirements
- Conduct detailed review of process maps, policies and procedures, and data metrics to determine scope and scope questions for multiple operational reviews
- Will conduct review of business partner processes and work closely with Lead and QA management to assess overall controls within operation
- Responsible for the completion of quality work papers within specified time frames as outlined by the Lead and/or Manager
- Will have input on the individual findings and justifications within scope section
- Basic knowledge of data analysis tools
- Basic knowledge of relational databases and database table structures sources (SQL, SAS and/or other programming tools)
- Basic knowledge of industry data sources
- Successful completion of an analyst assessment may be required
- 5+ years property claims adjusting experience, including 2+ years experience handling dwelling claims
- Advanced knowledge of Xactimate, Symbility, Simsol, or other estimating platform