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