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Automation Risk Analysis

Will “Corporate Claims Examiner” be Automated?

Historical Context: Oxford Study (2013)

Ranked #675 of 702. Estimated risk: 98.0%

Directly assessed by researchers as likely automatable
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AI Exposure Risk

56%

“Corporate Claims Examiner” will maybe be replaced by AI.

Based on the cognitive demands, communication requirements, and logical reasoning intrinsic to this occupation according to O*NET data, we project a 56% probability of disruption by generative AI and Large Language Models.

Automation & Robot Risk

33%

“Corporate Claims Examiner” will probably not be replaced by robots.

Evaluating the physical dexterity, repetitive motion tasks, and manual labor associated with this role, our analysis indicates a 33% likelihood of substitution by advanced robotics systems.

Personal & Financial Insights

Every occupation has a unique profile. For Claims Adjusters, Examiners, and Investigators, the Bureau of Labor Statistics and O*NET classify the day-to-day work broadly as: Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confer with legal counsel on claims requiring litigation. May also settle insurance claims.

Avg. Annual Salary $78,770
Avg. Hourly Wage $37.87
Available Jobs (US) 305,020
Job Title & Hierarchy Code (SOC) Claims Adjusters, Examiners, and Investigators #13-1031
Wage vs. National Median
ℹ️

Data is based on the reference occupation: “Claims Adjusters, Examiners, and Investigators”

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Core Skills & Abilities

  • Obtain credit information from banks and other credit services.

  • Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit.

  • Communicate with reinsurance brokers to obtain information necessary for processing claims.

  • Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.

  • Conduct detailed bill reviews to implement sound litigation management and expense control.

  • Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.

  • Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.

  • Pay and process claims within designated authority level.

  • Resolve complex, severe exposure claims, using high service oriented file handling.

  • Supervise claims adjusters to ensure that adjusters have followed proper methods.

  • Investigate and assess damage to property and create or review property damage estimates.

  • Examine titles to property to determine validity and act as company agent in transactions with property owners.

  • Refer questionable claims to investigator or claims adjuster for investigation or settlement.

  • Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.

  • Prepare reports to be submitted to company's data processing department.

  • Analyze information gathered by investigation and report findings and recommendations.

  • Collect evidence to support contested claims in court.

  • Confer with legal counsel on claims requiring litigation.

  • Present cases and participate in their discussion at claim committee meetings.

  • Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.

  • Examine claims forms and other records to determine insurance coverage.

  • Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.

  • Report overpayments, underpayments, and other irregularities.

  • Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.

  • Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.

  • Attend mediations or trials.

  • Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.

  • Negotiate claim settlements or recommend litigation when settlement cannot be negotiated.

  • Contact or interview claimants, doctors, medical specialists, or employers to get additional information.

Technologies & Software

  • Medical condition coding software
  • Zoom
  • CGI-AMS BureauLink Enterprise
  • Gemini for Workspace
  • Planful AI
  • Automatic Data Processing Autosource
  • Microsoft Excel
  • PhotoModeler
  • Apple Safari
  • Corporate Systems ClaimsPro
  • DeepSeek
  • StrataCare StrataWare eReview
  • MapScenes Evidence Recorder
  • Magnify Predictive Targeting System
  • CCC TL2000 Solution
  • Nova (Amazon)
  • Microsoft Office software
  • Claims processing administration and management software
  • Xactware Xactimate
  • Castek Insure3 Claims
  • Microsoft Access
  • Axonwave Fraud and Abuse Management System
  • Grok (xAI)
  • ARSoftware WinSMAC
  • Turtle Creek Software Goldenseal Architect
  • BCCORP Burkitt W5
  • Document management system software
  • Microsoft Word
  • InSystems Calligo Document Management System
  • Clear Technology Tranzax
  • Insurance claims fraud detection software
  • Microsoft Publisher
  • Business software applications
  • Alteryx AI
  • CSC Colossus
  • Injury Sciences EDR InSight
  • ISO ClaimSearch
  • CAD Zone Insurance
  • ADP software
  • LexisNexis RiskWise
  • Computerized voice stress analyzer CVSA software
  • Microsoft PowerPoint
  • CSC Automated Work Distributor AWD
  • Napkin AI
  • Microsoft Copilot
  • CCC GuidePost Decision Support
  • Kimi (Moonshot AI)
  • Tropics Claims Reserve Management
  • First Notice Systems ClaimCapture
  • CCC EZNet electronic communications network
  • Tableau AI
  • Mozilla Firefox
  • Simsol for Adjusters
  • Datanex ClaimTrac
  • Healthcare common procedure coding system HCPCS
  • AutoClaims Direct DirectLink
  • Visual Statement Investigator Suite
  • Meta Business AI
  • Bill review software
  • Hyland OnBase Enterprise Content Management
  • Fair Isaac Claims Advisor
  • Covansys ClaimConnect
  • DataRobot
  • Bramerhill ClaimsTech
  • Automatic Data Processing Claims Manager & Dispatch
  • IBM Fraud and Abuse Management System
  • Microsoft Outlook
  • Qwen (Alibaba)
  • CCC Pathways Appraisal Quality Solution
  • Bridium Claims 3
  • MapScenes Pro
  • ISO NetMap for Claims
  • Property damage, bodily injury, and liability estimation software
  • CSC Fault Evaluator
  • CCC Pathways Image Management Solution
  • Captiva InputAccel
  • Claude (Anthropic)
  • BCCORP W5 for Adjusters
  • 4n6xprt Systems StiffCalcs
  • ChatGPT (OpenAI)
  • Fair Isaac SmartAdvisor
  • CGI INSideOUT
  • QwikQuote software
  • Automatic Data Processing Estimating
  • Agency Management Systems AMS 360
  • Brightwork Alyce Claims Systems
  • Llama (Meta)
  • Perplexity AI
  • Hummingbird Legal Bill Review
  • Mistral (Mistral AI)
  • Gemini (Google)
  • Medical procedure coding software
  • Mobile wireless handheld communication devices
  • Handheld computers
  • Desktop computers
  • Total stations
  • Scanners
  • Personal digital assistants PDA
  • Tablet computers
  • Personal computers
  • Data collectors
  • Event data recorders
  • Measure markers
  • Field computers
  • Notebook computers

Alternative Job Titles