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