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