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