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