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”
- 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.
- Obtain credit information from banks and other credit services.
- Examine titles to property to determine validity and act as company agent in transactions with property owners.
- Examine claims forms and other records to determine insurance coverage.
- Collect evidence to support contested claims in court.
- 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.
- 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.
- 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.
Related Technology & Tools
- Event data recorders
- Desktop computers
- Field computers
- Data collectors
- Personal digital assistants PDA
- Measure markers
- Total stations
- Handheld computers
- Mobile wireless handheld communication devices
- Magnify Predictive Targeting System
- Bridium Claims 3
- Turtle Creek Software Goldenseal Architect
- Covansys ClaimConnect
- ARSoftware WinSMAC
- Document management system software
- CGI INSideOUT
- Microsoft Excel
- Hyland OnBase Enterprise Content Management
- Microsoft Office
- Microsoft Word
- Brightwork Alyce Claims Systems
- 4n6xprt Systems StiffCalcs
- CCC TL2000 Solution
- CCC Pathways Image Management Solution
- BCCORP Burkitt W5
- Axonwave Fraud and Abuse Management System
- Visual Statement Investigator Suite
- PhotoModeler
- CGI-AMS BureauLink Enterprise
- CCC Pathways Appraisal Quality Solution
- Property damage, bodily injury, and liability estimation software
- InSystems Calligo Document Management System
- ISO NetMap for Claims
- MapScenes Pro
- MapScenes Evidence Recorder
- Computerized voice stress analyzer CVSA software
- IBM Fraud and Abuse Management System
- Clear Technology Tranzax
- CCC EZNet electronic communications network
- Datanex ClaimTrac
- ADP software
- Captiva InputAccel
- CSC Colossus
- Autoclaims Direct DirectLink
- Automatic Data Processing Autosource
- Hummingbird Legal Bill Review
- Castek Insure3 Claims
- ISO ClaimSearch
- Insurance claims fraud detection software
- Agency Management Systems AMS 360
- Fair Isaac SmartAdvisor
- CCC GuidePost Decision Support
- Injury Sciences EDR InSight
- CAD Zone Insurance
- Simsol for Adjusters
- CSC Fault Evaluator
- Bramerhill ClaimsTech
- Automatic Data Processing Estimating
- LexisNexis RiskWise
- Corporate Systems ClaimsPro
- First Notice Systems ClaimCapture
- CSC Automated Work Distributor AWD
- QwikQuote software
- Bill review software
- Automatic Data Processing Claims Manager & Dispatch
- StrataCare StrataWare eReview
- Claims processing administration and management software