Will “Liability Claims Manager” be Replaced By Robots? 🤔
Unknown Chance of Automation
Sadly, the research paper did not provide any information about this occupation. Maybe have a look at our directory?
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 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
- Casualty Claims Supervisor
- Case Manager
Tasks for “Liability Claims Manager”
- Supervise claims adjusters to ensure that adjusters have followed proper methods.
- Resolve complex, severe exposure claims, using high service oriented file handling.
- Conduct detailed bill reviews to implement sound litigation management and expense control.
- Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
- Prepare reports to be submitted to company's data processing department.
- 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.
- 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.
- Communicate with reinsurance brokers to obtain information necessary for processing claims.
- 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.
- Confer with legal counsel on claims requiring litigation.
- 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.
- 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.
Related Technology & Tools
- Tablet computers
- Notebook computers
- Desktop computers
- Personal digital assistants PDA
- Scanners
- Personal computers
- Healthcare common procedure coding system HCPCS
- AutoClaims Direct DirectLink
- CGI INSideOUT
- CCC Pathways Appraisal Quality Solution
- Castek Insure3 Claims
- Automatic Data Processing Autosource
- Tropics Claims Reserve Management
- BCCORP W5 for Adjusters
- Fair Isaac Claims Advisor
- IBM Fraud and Abuse Management System
- Fair Isaac SmartAdvisor
- Bridium Claims 3
- Computerized voice stress analyzer CVSA software
- CSC Fault Evaluator
- Bill review software
- Agency Management Systems AMS 360
- Microsoft Excel
- First Notice Systems ClaimCapture
- Microsoft Office
- StrataCare StrataWare eReview
- LexisNexis RiskWise
- Automatic Data Processing Claims Manager & Dispatch
- Covansys ClaimConnect
- Microsoft Word
- ISO ClaimSearch
- CCC TL2000 Solution
- Axonwave Fraud and Abuse Management System
- CCC EZNet electronic communications network
- Medical procedure coding software
- CCC GuidePost Decision Support
- Bramerhill ClaimsTech
- Microsoft PowerPoint
- Hummingbird Legal Bill Review
- Hyland OnBase Enterprise Content Management
- Clear Technology Tranzax
- Insurance claims fraud detection software
- Medical condition coding software
- ISO NetMap for Claims
- InSystems Calligo Document Management System
- Document management system software
- Brightwork Alyce Claims Systems
- CSC Automated Work Distributor AWD
- Datanex ClaimTrac
- Captiva InputAccel
- Claims processing administration and management software
- Corporate Systems ClaimsPro
- Magnify Predictive Targeting System
- CCC Pathways Image Management Solution