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