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