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