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