Will “Claims Supervisor” 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
Review settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures. Report overpayments, underpayments, and other irregularities. Confer with legal counsel on claims requiring litigation.
Job Details
- The SOC (Standard Occupational Classification) code is 13-1031.01
☝️ Information based on the reference occupation “Claims Examiners, Property and Casualty Insurance”.
Also Known As…
- Claims Examiners, Property and Casualty Insurance
- Home Office Claim Specialist
- Customer Care Specialist
- Corporate Claims Examiner
- Claims Supervisor
- Claims Specialist
- Claims Representative
- Claims Manager
- Claims Examiner
- Claims Analyst
- Claims Adjuster
- Workers Compensation Examiner
- Workers Compensation Claims Examiner
- Worker's Compensation Claims Examiner
- Reinsurance Claim Analyst
- Property Damage Claims Adjustor
- Litigation Examiner
- Liability Claims Representative
- Liability Claims Manager
- Liability Claims Examiner
- Insurance Examiner
- Insurance Auditor
- Home Office Claims Examiner
- Executive Relations Specialist
- Claims Vice President
- Claims Director
- Claims Consultant
- Claims Auditor
- Claims Account Specialist
- Claims Account Manager
- Claim Auditor
- Check Examiner
- Casualty Claims Supervisor
- Case Manager
Tasks for “Claims Supervisor”
- Resolve complex, severe exposure claims, using high service oriented file handling.
- Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
- Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.
- Communicate with reinsurance brokers to obtain information necessary for processing claims.
- Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
- Conduct detailed bill reviews to implement sound litigation management and expense control.
- Present cases and participate in their discussion at claim committee meetings.
- Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
- Prepare reports to be submitted to company's data processing department.
- Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
- Confer with legal counsel on claims requiring litigation.
- Supervise claims adjusters to ensure that adjusters have followed proper methods.
- Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
- Pay and process claims within designated authority level.
- Report overpayments, underpayments, and other irregularities.
- Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Related Technology & Tools
- Notebook computers
- Desktop computers
- Personal digital assistants PDA
- Scanners
- Tablet computers
- Personal computers
- Bill review software
- Clear Technology Tranzax
- CGI INSideOUT
- Agency Management Systems AMS 360
- CCC Pathways Appraisal Quality Solution
- Computerized voice stress analyzer CVSA software
- BCCORP W5 for Adjusters
- Castek Insure3 Claims
- IBM Fraud and Abuse Management System
- Fair Isaac SmartAdvisor
- AutoClaims Direct DirectLink
- Microsoft Excel
- Fair Isaac Claims Advisor
- Brightwork Alyce Claims Systems
- Microsoft Word
- CSC Fault Evaluator
- CSC Automated Work Distributor AWD
- Medical procedure coding software
- CCC TL2000 Solution
- Microsoft PowerPoint
- Healthcare common procedure coding system HCPCS
- Magnify Predictive Targeting System
- Corporate Systems ClaimsPro
- CCC Pathways Image Management Solution
- Document management system software
- Insurance claims fraud detection software
- InSystems Calligo Document Management System
- Covansys ClaimConnect
- Bridium Claims 3
- Automatic Data Processing Autosource
- First Notice Systems ClaimCapture
- CCC GuidePost Decision Support
- Tropics Claims Reserve Management
- Bramerhill ClaimsTech
- CCC EZNet electronic communications network
- Axonwave Fraud and Abuse Management System
- Captiva InputAccel
- Microsoft Office
- ISO NetMap for Claims
- Automatic Data Processing Claims Manager & Dispatch
- Hummingbird Legal Bill Review
- ISO ClaimSearch
- StrataCare StrataWare eReview
- Medical condition coding software
- Datanex ClaimTrac
- LexisNexis RiskWise
- Claims processing administration and management software
- Hyland OnBase Enterprise Content Management