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