Will “Clinical Appeals Reviewer” be Replaced By Robots? 🤔
64% Chance of Automation
“Clinical Appeals Reviewer” will maybe be replaced by robots.
This job is ranked #353 out of #702, where higher means less likely to be replaced.
Conduct hearings to recommend or make decisions on claims concerning government programs or other government-related matters. Determine liability, sanctions, or penalties, or recommend the acceptance or rejection of claims or settlements.
- The SOC (Standard Occupational Classification) code is 23-1021.00
- The Mean Annual Wage in the U.S. is $ 95,240.00
- The Mean Hourly Wage is $ 45.00
- Currently, there are 14,540 people on this job
☝️ Information based on the reference occupation “Administrative Law Judges, Adjudicators, and Hearing Officers”.
Also Known As…
- Administrative Law Judges, Adjudicators, and Hearing Officers
- Workers' Compensation Hearings Officer
- Hearing Officer
- Claims Adjudicator
- Appeals Referee
- Appeals Examiner
- Administrative Law Judge
- Administrative Judge
- Administrative Hearing Officer
- Workforce Advisor
- Workers' Compensation Magistrate
- Workers' Compensation Commissioner
- Workers' Compensation Claims Examiner
- Veteran Appeals Reviewer
- US Administrative Law Judge (United States Administrative Law Judge)
- Unemployment Claims Adjudicator
- Traffic Court Referee
- Social Services Analyst
- Social Security Administrative Law Judge
- Parole Hearing Officer
- Legal Activity Adjudicator
- Justice of the Peace
- Housing Court Judge
- Hearing Examiner
- Employment Program Representative
- Disciplinary Hearing Officer
- Disability Hearing Officer
- County Ordinary
- Claims Examiner
- Appellate Conferee
- Appeals Officer
Tasks for “Clinical Appeals Reviewer”
- Review and evaluate data on documents, such as claim applications, birth or death certificates, and physician or employer records.
- Determine existence and amount of liability according to current laws, administrative and judicial precedents, and available evidence.
- Rule on exceptions, motions, and admissibility of evidence.
- Research and analyze laws, regulations, policies, and precedent decisions to prepare for hearings and to determine conclusions.
- Explain to claimants how they can appeal rulings that go against them.
- Conduct hearings to review and decide claims regarding issues such as social program eligibility, environmental protection, and enforcement of health and safety regulations.
- Authorize payment of valid claims and determine method of payment.
- Confer with individuals or organizations involved in cases to obtain relevant information.
- Conduct studies of appeals procedures in field agencies to ensure adherence to legal requirements and to facilitate determination of cases.
- Issue subpoenas and administer oaths in preparation for formal hearings.
- Monitor and direct the activities of trials and hearings to ensure that they are conducted fairly and that courts administer justice while safeguarding the legal rights of all involved parties.
- Prepare written opinions and decisions.
- Recommend the acceptance or rejection of claims or compromise settlements according to laws, regulations, policies, and precedent decisions.
Related Technology & Tools
- Teleconferencing equipment
- Courtroom microphones
- Laser facsimile machines
- Tablet computers
- Laptop computers
- Multiline telephone systems
- Personal computers
- Digital audio recorders
- Digital video players
- Desktop computers
- Computer laser printers
- Videoconferencing equipment
- Microsoft Office
- Adobe Systems Adobe Acrobat
- Videoconferencing software
- Email software
- Courtroom scheduling software
- Microsoft Word
- Web browser software
- Microsoft Excel
- Word processing software
- Online databases
- Instant messaging software
- Thomson Reuters WestLaw