Will “Claims Representative” be Replaced By Robots? 🤔
Unknown Chance of Automation
Sadly, the research paper did not provide any information about this occupation. Maybe have a look at our directory?
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 Examiner
- Claims Analyst
- Claims Adjuster
- Claim Representative
- 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 Representative
- 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 “Claims Representative”
- Communicate with former associates to verify employment record and to obtain background information regarding persons or businesses applying for credit.
- 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.
- Negotiate claim settlements and recommend litigation when settlement cannot be negotiated.
- 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.
- 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.
- Prepare report of findings of investigation.
- 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.
Related Technology & Tools
- Personal digital assistants PDA
- Desktop computers
- Total stations
- Mobile wireless handheld communication devices
- Measure markers
- Handheld computers
- Event data recorders
- Field computers
- Data collectors
- Agency Management Systems AMS 360
- CCC EZNet electronic communications network
- CSC Automated Work Distributor AWD
- Covansys ClaimConnect
- MapScenes Evidence Recorder
- StrataCare StrataWare eReview
- Brightwork Alyce Claims Systems
- Microsoft Excel
- CAD Zone Insurance
- ISO NetMap for Claims
- Claims processing administration and management software
- Bill review software
- BCCORP Burkitt W5
- CCC Pathways Appraisal Quality Solution
- Turtle Creek Software Goldenseal Architect
- Autoclaims Direct DirectLink
- Corporate Systems ClaimsPro
- CGI-AMS BureauLink Enterprise
- Magnify Predictive Targeting System
- ARSoftware WinSMAC
- Bridium Claims 3
- Simsol for Adjusters
- Castek Insure3 Claims
- Hyland OnBase Enterprise Content Management
- PhotoModeler
- Automatic Data Processing Autosource
- ISO ClaimSearch
- MapScenes Pro
- Insurance claims fraud detection software
- Property damage, bodily injury, and liability estimation software
- CCC Pathways Image Management Solution
- Computerized voice stress analyzer CVSA software
- Axonwave Fraud and Abuse Management System
- Bramerhill ClaimsTech
- CCC TL2000 Solution
- Visual Statement Investigator Suite
- First Notice Systems ClaimCapture
- Hummingbird Legal Bill Review
- Injury Sciences EDR InSight
- Document management system software
- InSystems Calligo Document Management System
- Automatic Data Processing Claims Manager & Dispatch
- Captiva InputAccel
- ADP software
- QwikQuote software
- CCC GuidePost Decision Support
- Microsoft Word
- IBM Fraud and Abuse Management System
- CSC Fault Evaluator
- Datanex ClaimTrac
- Clear Technology Tranzax
- Microsoft Office
- CSC Colossus
- Fair Isaac SmartAdvisor
- LexisNexis RiskWise
- Automatic Data Processing Estimating
- 4n6xprt Systems StiffCalcs
- CGI INSideOUT