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