Claims Examiner Resume Examples & Tips for 2025

As a Claims Examiner in Business & Analytics, you will evaluate and process complex insurance claims by analyzing data, reviewing medical records, and conducting detailed investigations to determine coverage eligibility and settlement amounts. This role requires strong analytical skills, knowledge of insurance policies and regulations, proficiency in data analysis software, and excellent decision-making abilities, along with a Bachelor's degree in Business, Finance, or related field and 3+ years of claims processing experience. The Claims Examiner serves as a critical link between the insurance company and its clients, ensuring accurate claim settlements while maintaining compliance with company policies and regulatory requirements, ultimately contributing to both customer satisfaction and company profitability.