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