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