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