Will “Casualty Claims Supervisor” be Replaced By Robots? 🤔
Unknown Chance of Automation
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Job Description
Review settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures. Report overpayments, underpayments, and other irregularities. Confer with legal counsel on claims requiring litigation.
Job Details
- The SOC (Standard Occupational Classification) code is 13-1031.01
☝️ Information based on the reference occupation “Claims Examiners, Property and Casualty Insurance”.
Also Known As…
- Claims Examiners, Property and Casualty Insurance
- Home Office Claim Specialist
- Customer Care Specialist
- Corporate Claims Examiner
- Claims Supervisor
- Claims Specialist
- Claims Representative
- Claims Manager
- Claims Examiner
- Claims Analyst
- Claims Adjuster
- Workers Compensation Examiner
- Workers Compensation Claims Examiner
- Worker's Compensation Claims Examiner
- Reinsurance Claim Analyst
- Property Damage Claims Adjustor
- Litigation Examiner
- Liability Claims Representative
- Liability Claims Manager
- Liability Claims Examiner
- Insurance Examiner
- Insurance Auditor
- Home Office Claims Examiner
- Executive Relations Specialist
- Claims Vice President
- Claims Director
- Claims Consultant
- Claims Auditor
- Claims Account Specialist
- Claims Account Manager
- Claim Auditor
- Check Examiner
- Case Manager
Tasks for “Casualty Claims Supervisor”
- Pay and process claims within designated authority level.
- Supervise claims adjusters to ensure that adjusters have followed proper methods.
- Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
- Confer with legal counsel on claims requiring litigation.
- Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
- Prepare reports to be submitted to company's data processing department.
- Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
- Communicate with reinsurance brokers to obtain information necessary for processing claims.
- Resolve complex, severe exposure claims, using high service oriented file handling.
- 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.
- Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
- Report overpayments, underpayments, and other irregularities.
- Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
- Present cases and participate in their discussion at claim committee meetings.
- Conduct detailed bill reviews to implement sound litigation management and expense control.
- 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.
Related Technology & Tools
- Tablet computers
- Personal digital assistants PDA
- Notebook computers
- Scanners
- Personal computers
- Desktop computers
- ISO ClaimSearch
- Healthcare common procedure coding system HCPCS
- Medical condition coding software
- Magnify Predictive Targeting System
- Microsoft PowerPoint
- IBM Fraud and Abuse Management System
- LexisNexis RiskWise
- StrataCare StrataWare eReview
- BCCORP W5 for Adjusters
- Tropics Claims Reserve Management
- CCC EZNet electronic communications network
- Bramerhill ClaimsTech
- Axonwave Fraud and Abuse Management System
- Document management system software
- Bill review software
- Bridium Claims 3
- AutoClaims Direct DirectLink
- Microsoft Excel
- CCC Pathways Image Management Solution
- InSystems Calligo Document Management System
- CSC Automated Work Distributor AWD
- Computerized voice stress analyzer CVSA software
- CGI INSideOUT
- Fair Isaac SmartAdvisor
- Medical procedure coding software
- Microsoft Word
- Hummingbird Legal Bill Review
- CSC Fault Evaluator
- Hyland OnBase Enterprise Content Management
- First Notice Systems ClaimCapture
- Automatic Data Processing Claims Manager & Dispatch
- Captiva InputAccel
- Agency Management Systems AMS 360
- Castek Insure3 Claims
- Automatic Data Processing Autosource
- CCC Pathways Appraisal Quality Solution
- Clear Technology Tranzax
- Claims processing administration and management software
- Insurance claims fraud detection software
- Corporate Systems ClaimsPro
- Brightwork Alyce Claims Systems
- Datanex ClaimTrac
- Fair Isaac Claims Advisor
- Microsoft Office
- Covansys ClaimConnect
- CCC TL2000 Solution
- CCC GuidePost Decision Support
- ISO NetMap for Claims