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