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