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