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”
- Refer questionable claims to investigator or claims adjuster for investigation or settlement.
- Prepare report of findings of investigation.
- Analyze information gathered by investigation and report findings and recommendations.
- Examine claims forms and other records to determine insurance coverage.
- Collect evidence to support contested claims in court.
- Obtain credit information from banks and other credit services.
- Examine titles to property to determine validity and act as company agent in transactions with property owners.
- 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.
- Investigate and assess damage to property and create or review property damage estimates.
- Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
- 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.
Related Technology & Tools
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- Handheld computers
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- Desktop computers
- Measure markers
- Mobile wireless handheld communication devices
- Personal digital assistants PDA
- PhotoModeler
- ISO NetMap for Claims
- Property damage, bodily injury, and liability estimation software
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- MapScenes Evidence Recorder
- Bramerhill ClaimsTech
- CCC Pathways Image Management Solution
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- Bridium Claims 3
- CCC GuidePost Decision Support
- StrataCare StrataWare eReview
- InSystems Calligo Document Management System
- Automatic Data Processing Autosource
- CGI INSideOUT
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- CSC Colossus
- 4n6xprt Systems StiffCalcs
- Fair Isaac SmartAdvisor
- CSC Automated Work Distributor AWD
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- Simsol for Adjusters
- CGI-AMS BureauLink Enterprise
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- Agency Management Systems AMS 360
- Hummingbird Legal Bill Review
- MapScenes Pro
- CAD Zone Insurance
- CCC EZNet electronic communications network
- Bill review software
- Datanex ClaimTrac
- Automatic Data Processing Estimating
- Microsoft Excel
- Document management system software
- Claims processing administration and management software
- Covansys ClaimConnect
- Brightwork Alyce Claims Systems
- Clear Technology Tranzax
- BCCORP Burkitt W5
- Autoclaims Direct DirectLink
- Corporate Systems ClaimsPro
- Injury Sciences EDR InSight
- First Notice Systems ClaimCapture
- Visual Statement Investigator Suite
- Turtle Creek Software Goldenseal Architect
- LexisNexis RiskWise
- ISO ClaimSearch
- Axonwave Fraud and Abuse Management System
- Microsoft Word