Will “Claims 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 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 Specialist”
- Refer questionable claims to investigator or claims adjuster for investigation or settlement.
- Examine claims forms and other records to determine insurance coverage.
- 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.
- 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.
- 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.
- Prepare report of findings of investigation.
- 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.
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- Obtain credit information from banks and other credit services.
Related Technology & Tools
- Data collectors
- Mobile wireless handheld communication devices
- Handheld computers
- Total stations
- Field computers
- Measure markers
- Event data recorders
- Personal digital assistants PDA
- Desktop computers
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- Hummingbird Legal Bill Review
- Computerized voice stress analyzer CVSA software
- Covansys ClaimConnect
- Agency Management Systems AMS 360
- CCC TL2000 Solution
- First Notice Systems ClaimCapture
- QwikQuote software
- Microsoft Office
- CGI-AMS BureauLink Enterprise
- ARSoftware WinSMAC
- LexisNexis RiskWise
- Injury Sciences EDR InSight
- Brightwork Alyce Claims Systems
- Axonwave Fraud and Abuse Management System
- ISO ClaimSearch
- Claims processing administration and management software
- 4n6xprt Systems StiffCalcs
- ADP software
- Microsoft Word
- MapScenes Pro
- Autoclaims Direct DirectLink
- Hyland OnBase Enterprise Content Management
- Simsol for Adjusters
- CSC Fault Evaluator
- Castek Insure3 Claims
- CCC EZNet electronic communications network
- MapScenes Evidence Recorder
- Magnify Predictive Targeting System
- Automatic Data Processing Estimating
- Property damage, bodily injury, and liability estimation software
- CSC Automated Work Distributor AWD
- Fair Isaac SmartAdvisor
- CCC Pathways Image Management Solution
- CSC Colossus
- Visual Statement Investigator Suite
- CGI INSideOUT
- PhotoModeler
- Automatic Data Processing Claims Manager & Dispatch
- CCC GuidePost Decision Support
- Insurance claims fraud detection software
- Corporate Systems ClaimsPro
- Automatic Data Processing Autosource
- Bridium Claims 3
- StrataCare StrataWare eReview
- Clear Technology Tranzax
- Document management system software
- IBM Fraud and Abuse Management System
- CCC Pathways Appraisal Quality Solution
- CAD Zone Insurance
- InSystems Calligo Document Management System
- Captiva InputAccel
- Datanex ClaimTrac
- BCCORP Burkitt W5
- Turtle Creek Software Goldenseal Architect
- ISO NetMap for Claims
- Microsoft Excel
- Bramerhill ClaimsTech