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Automation Risk Analysis

Will “Workers' Compensation 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%

“Workers' Compensation 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%

“Workers' Compensation 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

  • 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.

  • 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.

  • 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.

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

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

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

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

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

  • Attend mediations or trials.

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

  • 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.

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

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

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

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

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

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

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

  • Collect evidence to support contested claims in court.

  • Confer with legal counsel on claims requiring litigation.

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

  • Pay and process claims within designated authority level.

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

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

  • Report overpayments, underpayments, and other irregularities.

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

  • Obtain credit information from banks and other credit services.

Technologies & Software

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

Alternative Job Titles