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