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.
- 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.
- 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.
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability.
- Obtain credit information from banks and other credit services.
- Collect evidence to support contested claims in court.
- Analyze information gathered by investigation and report findings and recommendations.
- 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.
- Prepare report of findings of investigation.
- Negotiate claim settlements and recommend litigation when settlement cannot be negotiated.
Related Technology & Tools
- Data collectors
- Field computers
- Measure markers
- Desktop computers
- Event data recorders
- Handheld computers
- Total stations
- Personal digital assistants PDA
- Mobile wireless handheld communication devices
- LexisNexis RiskWise
- Bramerhill ClaimsTech
- Bridium Claims 3
- CGI-AMS BureauLink Enterprise
- CAD Zone Insurance
- Simsol for Adjusters
- Agency Management Systems AMS 360
- Castek Insure3 Claims
- CCC Pathways Image Management Solution
- Microsoft Word
- Autoclaims Direct DirectLink
- ISO ClaimSearch
- Microsoft Excel
- CCC Pathways Appraisal Quality Solution
- Hyland OnBase Enterprise Content Management
- Clear Technology Tranzax
- ADP software
- InSystems Calligo Document Management System
- Microsoft Office
- Claims processing administration and management software
- Automatic Data Processing Autosource
- Covansys ClaimConnect
- CCC TL2000 Solution
- BCCORP Burkitt W5
- Computerized voice stress analyzer CVSA software
- First Notice Systems ClaimCapture
- Turtle Creek Software Goldenseal Architect
- Corporate Systems ClaimsPro
- CGI INSideOUT
- MapScenes Pro
- Magnify Predictive Targeting System
- Hummingbird Legal Bill Review
- CCC GuidePost Decision Support
- Brightwork Alyce Claims Systems
- MapScenes Evidence Recorder
- Datanex ClaimTrac
- CSC Colossus
- QwikQuote software
- CCC EZNet electronic communications network
- Automatic Data Processing Claims Manager & Dispatch
- CSC Fault Evaluator
- Fair Isaac SmartAdvisor
- Bill review software
- IBM Fraud and Abuse Management System
- Insurance claims fraud detection software
- ISO NetMap for Claims
- PhotoModeler
- Visual Statement Investigator Suite
- Document management system software
- 4n6xprt Systems StiffCalcs
- Injury Sciences EDR InSight
- Property damage, bodily injury, and liability estimation software
- StrataCare StrataWare eReview
- ARSoftware WinSMAC
- Automatic Data Processing Estimating
- CSC Automated Work Distributor AWD
- Axonwave Fraud and Abuse Management System
- Captiva InputAccel