Claims Examiner Assistant Interview Questions
The candidate is expected to provide specific examples of their past experiences and demonstrate how they have successfully handled challenging situations in their previous roles. They should also be able to articulate their knowledge of insurance policies and procedures and show their ability to quickly learn and adapt to new systems.
The candidate may be asked about their methods for staying organized and meeting deadlines, their communication style, and their willingness to work as part of a team. It is also important for the candidate to highlight their attention to detail and accuracy in data management.
Overall, the interview for a Claims Examiner Assistant position will aim to assess the candidate's experience, skills, and attitudes towards working in the insurance industry, while giving the candidate a chance to demonstrate their abilities and problem-solving qualities.
Interviewer: Good morning, thank you for coming in today. Can you start by telling me a little about yourself?
Candidate: Sure, my name is Jane and I recently graduated with a degree in Business Administration. I have some experience in customer service and administrative support.
Interviewer: Great. How do you feel your past experiences have prepared you for the role of Claims Examiner Assistant?
Candidate: My experience in customer service has helped me develop strong communication and problem-solving skills, which I believe are essential in this role. Additionally, my background in business administration has given me a good understanding of the importance of attention to detail and organization.
Interviewer: Can you describe your experience working with insurance claims?
Candidate: I don't have any direct experience with insurance claims, but I have worked in customer service roles where I've had to deal with customer inquiries and complaints. I think that experience would be relevant in this role as well.
Interviewer: Can you walk me through your process for reviewing and evaluating claims?
Candidate: While I have no direct experience in evaluating claims, I imagine it would involve reviewing the claim to ensure all necessary documentation is included and accurate, investigating the situation and determining liability, and working with the claims examiner to determine the appropriate course of action.
Interviewer: Can you give an example of a time when you had to handle a difficult or upset customer?
Candidate: I used to work in a call center, and there was a customer who was extremely upset because their order was delayed. I listened to their complaints and assured them that I would do everything in my power to get their order to them as soon as possible. I also informed my manager of the situation so that they could follow up with the customer and keep them updated on the status of their order.
Interviewer: How do you prioritize your workload and manage multiple tasks at once?
Candidate: In my previous roles, I've used task lists and calendars to prioritize my workload and ensure that I meet all deadlines. I also try to break down bigger projects into smaller tasks so that I can work on them in smaller increments.
Interviewer: How do you handle confidential or sensitive information?
Candidate: I understand the importance of confidentiality and would take all necessary steps to ensure that any sensitive information is kept secure. This may include password-protecting documents or only accessing them on secure networks.
Interviewer: Can you give an example of a time when you went above and beyond for a customer or coworker?
Candidate: During my time as a receptionist, there was a coworker who was having trouble with their computer. I took the initiative to troubleshoot the issue and was able to fix it for them. They were grateful for the help and it helped boosted our professional relationship.
Interviewer: How do you stay organized and ensure your work is accurate?
Candidate: I stay organized by keeping detailed notes and documentation of my work, and I double-check my work for accuracy before submitting it.
Interviewer: How do you handle constructive criticism or feedback?
Candidate: I welcome constructive criticism as an opportunity to improve and grow. I try to take the feedback as a learning opportunity and apply it to my work going forward.
Interviewer: Can you tell me about a time when you had to complete a task with a tight deadline?
Candidate: At my previous job, there was an urgent project that needed to be completed by the end of the day. I prioritized that task and communicated with my team to ensure that everyone was on the same page and working efficiently. We were able to complete the project on time.
Interviewer: How do you handle stressful or high-pressure situations?
Candidate: I try to remain calm and focused during stressful situations, and prioritize my workload accordingly. I also try to take a step back and assess the situation objectively, breaking down the problem into smaller parts to find a solution.
Interviewer: Can you describe your experience with data entry and record-keeping?
Candidate: In my previous roles, I've kept detailed records of customer interactions and transactions. I'm comfortable working with data-entry software and understand how important accuracy and attention to detail is in this role.
Interviewer: How do you remain up-to-date on industry trends and new regulations?
Candidate: I try to stay informed by reading industry publications and attending relevant conferences and events. I'm also open to learning from coworkers with more experience in the field.
Interviewer: Lastly, do you have any questions for me about the role or the company?
Candidate: Yes, can you tell me more about the company culture and what you see as the biggest challenges in this role?
Scenario Questions
1. Scenario: A policyholder has filed a claim for damages to their car due to a hailstorm. The estimate provided by the repair shop is $3,500 but the policy limit for hail damage is only $2,500. What would be your course of action?
Candidate Answer: My course of action would be to process the claim for the policy limit of $2,500 and inform the policyholder of the limit for hail damage coverage. I would also explain any other options available, such as filing a claim under comprehensive coverage if applicable.
2. Scenario: A claimant has submitted a medical bill for $1,200 but their policy only covers up to $1,000 for that particular service. The claimant is insisting that the bill was necessary and they should not be responsible for the extra $200. How would you handle this situation?
Candidate Answer: I would review the policy language to confirm the coverage limit for that particular service. If it is indeed $1,000, I would explain to the claimant that unfortunately the policy only covers up to that amount and they would be responsible for the remaining $200. I would also offer any assistance or resources available to help with negotiating the bill with their medical provider.
3. Scenario: A policyholder has filed a claim for a stolen item that was not covered under their policy. They are insisting that the item was stolen and they should be compensated for it. How would you handle this situation?
Candidate Answer: I would review the policy language and confirm that the stolen item is indeed not covered under the policy. If that is the case, I would explain to the policyholder that unfortunately the policy does not cover that particular item and we would not be able to compensate them for the loss. I would also provide any resources or suggestions for seeking compensation elsewhere, such as filing a police report.
4. Scenario: A claimant has submitted a claim for property damage caused by their neighbor's tree. However, upon inspection, it is determined that the damage was caused by the claimant's own negligence in not properly maintaining their property. How would you handle this situation?
Candidate Answer: I would inform the claimant that after inspection, it was determined that the damage was caused by their own negligence in not properly maintaining their property. I would explain that in this case, the claim would not be covered under the policy as negligence is not typically covered. I would also provide any resources or suggestions for addressing the property damage, such as contacting a contractor or landscaper.
5. Scenario: A policyholder has filed a claim for water damage to their home. The estimate for repairs is $8,000 but there is a $1,000 deductible. How much would the policyholder be reimbursed for their claim?
Candidate Answer: The policyholder would be reimbursed for the amount of the repairs minus the deductible, which would be $7,000 in this case.