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Automation Risk Analysis

Will “Claims Representative (Claims Rep)” be Automated?

Historical Context: Oxford Study (2013)

Ranked #689 of 702. Estimated risk: 98.0%

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AI Exposure Risk

57%

“Claims Representative (Claims Rep)” 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 57% probability of disruption by generative AI and Large Language Models.

Automation & Robot Risk

33%

“Claims Representative (Claims Rep)” 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 Insurance Claims and Policy Processing Clerks, the Bureau of Labor Statistics and O*NET classify the day-to-day work broadly as: Process new insurance policies, modifications to existing policies, and claims forms. Obtain information from policyholders to verify the accuracy and completeness of information on claims forms, applications and related documents, and company records. Update existing policies and company records to reflect changes requested by policyholders and insurance company representatives.

Avg. Annual Salary $51,980
Avg. Hourly Wage $24.99
Available Jobs (US) 229,070
Job Title & Hierarchy Code (SOC) Insurance Claims and Policy Processing Clerks #43-9041
Wage vs. National Median
ℹ️

Data is based on the reference occupation: “Insurance Claims and Policy Processing Clerks”

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Core Skills & Abilities

  • Collect initial premiums and issue receipts.

  • Contact insured or other involved persons to obtain missing information.

  • Pay small claims.

  • Post or attach information to claim file.

  • Correspond with insured or agent to obtain information or to inform them of account status or changes.

  • Transcribe data to worksheets, and enter data into computer for use in preparing documents and adjusting accounts.

  • Examine letters from policyholders or agents, original insurance applications, and other company documents to determine if changes are needed and effects of changes.

  • Organize or work with detailed office or warehouse records, maintaining files for each policyholder, including policies that are to be reinstated or cancelled.

  • Obtain computer printout of policy cancellations, or retrieve cancellation cards from file.

  • Interview clients and take their calls to provide customer service and obtain information on claims.

  • Process and record new insurance policies and claims.

  • Organize or work with detailed office or warehouse records, using computers to enter, access, search or retrieve data.

  • Compare information from application to criteria for policy reinstatement, and approve reinstatement when criteria are met.

  • Enter insurance- and claims-related information into database systems.

  • Provide customer service, such as limited instructions on proceeding with claims or referrals to auto repair facilities or local contractors.

  • Review insurance policy to determine coverage.

  • Calculate amount of claim.

  • Notify insurance agent and accounting department of policy cancellation.

  • Transmit claims for payment or further investigation.

  • Calculate premiums, refunds, commissions, adjustments, or new reserve requirements, using insurance rate standards.

  • Process, prepare, and submit business or government forms, such as submitting applications for coverage to insurance carriers.

  • Prepare insurance claim forms or related documents, and review them for completeness.

  • Compose business correspondence for supervisors, managers, and professionals.

  • Review and verify data, such as age, name, address, and principal sum and value of property, on insurance applications and policies.

  • Modify, update, or process existing policies and claims to reflect any change in beneficiary, amount of coverage, or type of insurance.

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Alternative Job Titles