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