Will “Claim Agent” be Replaced By Robots? 🤔
Unknown Chance of Automation
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Job Description
Investigate, analyze, and determine the extent of insurance company's liability concerning personal, casualty, or property loss or damages, and attempt to effect settlement with claimants. Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Calculate benefit payments and approve payment of claims within a certain monetary limit.
Job Details
- The SOC (Standard Occupational Classification) code is 13-1031.02
☝️ Information based on the reference occupation “Insurance Adjusters, Examiners, and Investigators”.
Also Known As…
- Insurance Adjusters, Examiners, and Investigators
- Litigation Claim Representative
- Independent Insurance Adjuster
- General Adjuster
- Field Liability Generalist
- Claims Specialist
- Claims Representative
- Claims Examiner
- Claims Analyst
- Claims Adjuster
- Claim Representative
- Workers Compensation Claims Adjuster
- Telephone Claims Representative
- Salvage Determiner
- Residential Insurance Inspector
- Property Claims Adjuster
- Property Adjuster
- Multi-line Claims Adjuster
- Medical Claims Specialist
- Medical Claims Examiner
- Medical Claims Analyst
- Material Damage Adjuster
- Job Estimator
- Investigator
- Insurance Inspector
- Insurance Claims Adjuster
- Insurance Appraiser
- Insurance Adjuster
- Inspector
- Health Claims Examiner
- Fire Adjuster
- Field Adjuster
- Examiner
- Estimator
- Disability Specialist
- Disability Examiner
- Compensation Adjuster
- Clerical Adjuster
- Claims Service Adjustor
- Claims Manager
- Claims Assistant
- Claims Adjustor
- Claim Specialist
- Claim Processor
- Claim Investigator
- Claim Inspector
- Claim Examiner
- Claim Approver
- Claim Adjuster
- Catastrophe Claims Supervisor
- Building Appraiser
- Bodily Injury Adjuster
- Benefit Authorizer
- Auto Claims Adjuster
- Arson Investigator
- Appraiser
- Adjustment Clerk
- Adjuster
- Accident Investigator
Tasks for “Claim Agent”
- Investigate and assess damage to property and create or review property damage estimates.
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- Communicate with former associates to verify employment record and to obtain background information regarding persons or businesses applying for credit.
- Examine titles to property to determine validity and act as company agent in transactions with property owners.
- Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
- Analyze information gathered by investigation and report findings and recommendations.
- Obtain credit information from banks and other credit services.
- Prepare report of findings of investigation.
- Refer questionable claims to investigator or claims adjuster for investigation or settlement.
- Examine claims forms and other records to determine insurance coverage.
- Negotiate claim settlements and recommend litigation when settlement cannot be negotiated.
- Collect evidence to support contested claims in court.
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
Related Technology & Tools
- Field computers
- Total stations
- Event data recorders
- Measure markers
- Desktop computers
- Handheld computers
- Personal digital assistants PDA
- Mobile wireless handheld communication devices
- Data collectors
- Captiva InputAccel
- CSC Fault Evaluator
- Axonwave Fraud and Abuse Management System
- Agency Management Systems AMS 360
- Insurance claims fraud detection software
- Simsol for Adjusters
- Automatic Data Processing Claims Manager & Dispatch
- IBM Fraud and Abuse Management System
- Bill review software
- Clear Technology Tranzax
- Bridium Claims 3
- Magnify Predictive Targeting System
- CSC Automated Work Distributor AWD
- CSC Colossus
- Datanex ClaimTrac
- InSystems Calligo Document Management System
- PhotoModeler
- Hyland OnBase Enterprise Content Management
- CCC GuidePost Decision Support
- Document management system software
- Castek Insure3 Claims
- StrataCare StrataWare eReview
- MapScenes Pro
- CCC Pathways Image Management Solution
- Microsoft Office
- First Notice Systems ClaimCapture
- ISO ClaimSearch
- ISO NetMap for Claims
- ARSoftware WinSMAC
- 4n6xprt Systems StiffCalcs
- Fair Isaac SmartAdvisor
- Hummingbird Legal Bill Review
- CGI-AMS BureauLink Enterprise
- Computerized voice stress analyzer CVSA software
- Bramerhill ClaimsTech
- Automatic Data Processing Autosource
- Turtle Creek Software Goldenseal Architect
- Microsoft Excel
- Claims processing administration and management software
- Injury Sciences EDR InSight
- Corporate Systems ClaimsPro
- MapScenes Evidence Recorder
- Automatic Data Processing Estimating
- ADP software
- Microsoft Word
- QwikQuote software
- CCC Pathways Appraisal Quality Solution
- Brightwork Alyce Claims Systems
- CCC TL2000 Solution
- LexisNexis RiskWise
- Visual Statement Investigator Suite
- CAD Zone Insurance
- CCC EZNet electronic communications network
- BCCORP Burkitt W5
- Property damage, bodily injury, and liability estimation software
- CGI INSideOUT
- Autoclaims Direct DirectLink
- Covansys ClaimConnect