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”
- Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
- Resolve complex, severe exposure claims, using high service oriented file handling.
- 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.
- Confer with legal counsel on claims requiring litigation.
- Supervise claims adjusters to ensure that adjusters have followed proper methods.
- Communicate with reinsurance brokers to obtain information necessary for processing claims.
- Conduct detailed bill reviews to implement sound litigation management and expense control.
- Present cases and participate in their discussion at claim committee meetings.
- Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
- Report overpayments, underpayments, and other irregularities.
- Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
- 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.
- Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
- 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.
- Pay and process claims within designated authority level.
Related Technology & Tools
- Personal digital assistants PDA
- Notebook computers
- Tablet computers
- Desktop computers
- Scanners
- Personal computers
- Microsoft PowerPoint
- BCCORP W5 for Adjusters
- InSystems Calligo Document Management System
- StrataCare StrataWare eReview
- Microsoft Excel
- CCC GuidePost Decision Support
- Castek Insure3 Claims
- Fair Isaac SmartAdvisor
- Microsoft Word
- Automatic Data Processing Autosource
- First Notice Systems ClaimCapture
- Corporate Systems ClaimsPro
- CSC Automated Work Distributor AWD
- Bramerhill ClaimsTech
- Automatic Data Processing Claims Manager & Dispatch
- Fair Isaac Claims Advisor
- Insurance claims fraud detection software
- Healthcare common procedure coding system HCPCS
- Covansys ClaimConnect
- CCC EZNet electronic communications network
- Clear Technology Tranzax
- AutoClaims Direct DirectLink
- Datanex ClaimTrac
- Brightwork Alyce Claims Systems
- Captiva InputAccel
- Claims processing administration and management software
- Hyland OnBase Enterprise Content Management
- IBM Fraud and Abuse Management System
- CCC Pathways Image Management Solution
- Microsoft Office
- Medical procedure coding software
- ISO NetMap for Claims
- CGI INSideOUT
- Tropics Claims Reserve Management
- Bill review software
- CSC Fault Evaluator
- Medical condition coding software
- Magnify Predictive Targeting System
- Axonwave Fraud and Abuse Management System
- Agency Management Systems AMS 360
- Bridium Claims 3
- Computerized voice stress analyzer CVSA software
- ISO ClaimSearch
- CCC TL2000 Solution
- LexisNexis RiskWise
- Document management system software
- CCC Pathways Appraisal Quality Solution
- Hummingbird Legal Bill Review