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