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