Will “Claim Approver” 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 Agent
- 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 Approver”
- Analyze information gathered by investigation and report findings and recommendations.
- Investigate and assess damage to property and create or review property damage estimates.
- Obtain credit information from banks and other credit services.
- Refer questionable claims to investigator or claims adjuster for investigation or settlement.
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- 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.
- Examine titles to property to determine validity and act as company agent in transactions with property owners.
- Prepare report of findings of investigation.
- Examine claims forms and other records to determine insurance coverage.
- Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
- Collect evidence to support contested claims in court.
Related Technology & Tools
- Mobile wireless handheld communication devices
- Handheld computers
- Event data recorders
- Data collectors
- Total stations
- Personal digital assistants PDA
- Field computers
- Desktop computers
- Measure markers
- Turtle Creek Software Goldenseal Architect
- Document management system software
- Automatic Data Processing Autosource
- First Notice Systems ClaimCapture
- Hyland OnBase Enterprise Content Management
- CGI INSideOUT
- Castek Insure3 Claims
- Captiva InputAccel
- CSC Fault Evaluator
- PhotoModeler
- Property damage, bodily injury, and liability estimation software
- Hummingbird Legal Bill Review
- Bramerhill ClaimsTech
- Computerized voice stress analyzer CVSA software
- Magnify Predictive Targeting System
- Injury Sciences EDR InSight
- Insurance claims fraud detection software
- InSystems Calligo Document Management System
- CCC TL2000 Solution
- CCC Pathways Image Management Solution
- Brightwork Alyce Claims Systems
- MapScenes Evidence Recorder
- CGI-AMS BureauLink Enterprise
- CCC EZNet electronic communications network
- Automatic Data Processing Estimating
- Axonwave Fraud and Abuse Management System
- Microsoft Office
- LexisNexis RiskWise
- CAD Zone Insurance
- ADP software
- Microsoft Word
- CCC GuidePost Decision Support
- MapScenes Pro
- CCC Pathways Appraisal Quality Solution
- Covansys ClaimConnect
- Agency Management Systems AMS 360
- ARSoftware WinSMAC
- Clear Technology Tranzax
- Simsol for Adjusters
- Automatic Data Processing Claims Manager & Dispatch
- Autoclaims Direct DirectLink
- Datanex ClaimTrac
- Corporate Systems ClaimsPro
- Claims processing administration and management software
- Visual Statement Investigator Suite
- 4n6xprt Systems StiffCalcs
- QwikQuote software
- Fair Isaac SmartAdvisor
- ISO NetMap for Claims
- BCCORP Burkitt W5
- Bill review software
- CSC Automated Work Distributor AWD
- Microsoft Excel
- IBM Fraud and Abuse Management System
- CSC Colossus
- StrataCare StrataWare eReview
- ISO ClaimSearch
- Bridium Claims 3