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