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”
- Examine claims forms and other records to determine insurance coverage.
- Analyze information gathered by investigation and report findings and recommendations.
- Obtain credit information from banks and other credit services.
- Refer questionable claims to investigator or claims adjuster for investigation or settlement.
- Collect evidence to support contested claims in court.
- Prepare report of findings of investigation.
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- 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.
- Investigate and assess damage to property and create or review property damage estimates.
- Negotiate claim settlements and recommend litigation when settlement cannot be negotiated.
- Communicate with former associates to verify employment record and to obtain background information regarding persons or businesses applying for credit.
Related Technology & Tools
- Data collectors
- Handheld computers
- Mobile wireless handheld communication devices
- Personal digital assistants PDA
- Desktop computers
- Field computers
- Total stations
- Event data recorders
- Measure markers
- Captiva InputAccel
- MapScenes Evidence Recorder
- CSC Fault Evaluator
- CAD Zone Insurance
- ARSoftware WinSMAC
- CCC EZNet electronic communications network
- Hyland OnBase Enterprise Content Management
- PhotoModeler
- Corporate Systems ClaimsPro
- CSC Colossus
- Microsoft Excel
- Bill review software
- Datanex ClaimTrac
- Turtle Creek Software Goldenseal Architect
- Axonwave Fraud and Abuse Management System
- Computerized voice stress analyzer CVSA software
- Visual Statement Investigator Suite
- Autoclaims Direct DirectLink
- CCC TL2000 Solution
- CGI INSideOUT
- Automatic Data Processing Estimating
- IBM Fraud and Abuse Management System
- Property damage, bodily injury, and liability estimation software
- Covansys ClaimConnect
- ADP software
- Agency Management Systems AMS 360
- ISO NetMap for Claims
- CCC Pathways Image Management Solution
- Claims processing administration and management software
- Clear Technology Tranzax
- CCC Pathways Appraisal Quality Solution
- Brightwork Alyce Claims Systems
- StrataCare StrataWare eReview
- Hummingbird Legal Bill Review
- Microsoft Office
- 4n6xprt Systems StiffCalcs
- InSystems Calligo Document Management System
- CCC GuidePost Decision Support
- LexisNexis RiskWise
- First Notice Systems ClaimCapture
- Microsoft Word
- Castek Insure3 Claims
- ISO ClaimSearch
- Automatic Data Processing Claims Manager & Dispatch
- Bridium Claims 3
- Bramerhill ClaimsTech
- Automatic Data Processing Autosource
- QwikQuote software
- Fair Isaac SmartAdvisor
- Injury Sciences EDR InSight
- Magnify Predictive Targeting System
- Insurance claims fraud detection software
- Simsol for Adjusters
- MapScenes Pro
- BCCORP Burkitt W5
- CSC Automated Work Distributor AWD
- Document management system software
- CGI-AMS BureauLink Enterprise