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