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