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