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