50 Performance Review Phrases for Claims Examiners

Self Assessment Phrases - Achievements

• I reviewed claims thoroughly, checking documentation against policy terms before making a determination.
• I kept my caseload moving steadily while still giving each file the attention it needed.
• I identified inconsistencies in a claim involving [type of loss] that warranted further investigation.
• I communicated clearly with claimants about what documentation was needed and why.
• I coordinated with adjusters and investigators when a claim required additional review.
• I applied policy language accurately even on claims with unusual or ambiguous circumstances.
• I documented my decisions clearly so the file could withstand audit or appeal.
• I stayed current on regulatory and policy changes that affected how claims were evaluated.
• I handled a claimant's frustration about a delay professionally while working to move their file along.
• I flagged a pattern of similar claims from [source or provider], which prompted a closer review.

Self Assessment Phrases - Growth and Development

• I want to get faster at processing straightforward claims so more time goes to complex ones.
• I am working on explaining denials to claimants in a way that is clear without sounding dismissive.
• I would like to deepen my knowledge of [type of claim] so I can evaluate those cases more confidently.
• I sometimes request more documentation than a claim strictly needs and want to calibrate that better.
• I plan to get more comfortable pushing back when a claim looks incomplete or inconsistent.
• I want to improve how quickly I recognize claims that need to be escalated for investigation.
• I recognize I could ask clarifying questions earlier instead of waiting until close to a deadline.
• I would benefit from more exposure to complex claim types outside my usual caseload.
• I want to get better at spotting trends across claims rather than reviewing each one in isolation.
• I plan to work on my speed with the claims system so processing time drops without cutting corners.

Peer Review Phrases

• They review claims thoroughly, which makes their files easy to pick up if a second opinion is needed.
• They are quick to share guidance when a colleague is unsure how to handle an unusual claim.
• They document their reasoning clearly, which helps if a claim is ever appealed or audited.
• They communicate professionally with claimants, even when the outcome is a denial.
• They flag questionable claims early instead of letting them sit until the deadline approaches.
• They stay current on policy and regulatory changes and are a reliable resource for the team.
• They balance thoroughness with turnaround time and rarely let files stall.
• They are approachable when a coworker wants a second opinion on a borderline claim.
• They caught an issue with [type of documentation] on a shared file that changed the outcome.
• They handle high volume periods without letting quality slip on individual claims.

Manager Review Phrases - Strengths

• They review claims carefully while still using sound judgment on ambiguous cases.
• They keep turnaround times steady even during periods of higher claim volume.
• They document their decisions clearly, which supports audits and appeals.
• They communicate outcomes to claimants professionally, which reduces follow up complaints.
• They stay current on policy and regulatory changes and apply them correctly.
• They are dependable about flagging unusual claim patterns to the team.
• They collaborate well with investigators and adjusters when a claim needs additional input.
• They are reliable with deadlines and rarely need files chased down.
• They mentor newer examiners on how to evaluate complex claims.
• They identified a claim pattern involving [issue], which led to a useful process change.

Manager Review Phrases - Areas to Develop

• They could work on turning around straightforward claims more quickly so complex ones get more attention.
• They sometimes request more documentation than the claim actually requires, which slows the process down.
• They would benefit from more practice explaining denials to claimants in a way that reduces follow up disputes.
• They tend to escalate borderline claims rather than using judgment within their authority level.
• They could improve how consistently they document rationale across similar claims.
• They occasionally need reminders about updated policy language after a change.
• They would gain from additional training on [type of claim].
• They could build more confidence pushing back on incomplete submissions from claimants or providers.
• They sometimes underestimate how a small detail in a claim affects the overall evaluation.
• They would benefit from spotting trends across their caseload rather than reviewing claims purely one at a time.

How to use these phrases

Don't paste these in verbatim. Pick the two or three closest to what you actually did, then make them specific: swap the generic claim for your own project, metric, or outcome. Use the rest as a checklist of themes worth covering in a Claims Examiner review, and see the Perform Review blog for guides on structuring the full review.