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