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