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