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