Will “Claim Examiner” 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
- 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 Manager
- Claims Assistant
- Claims Adjustor
- Claim Specialist
- Claim Processor
- Claim Investigator
- Claim Inspector
- 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 Examiner”
- Communicate with former associates to verify employment record and to obtain background information regarding persons or businesses applying for credit.
- Examine claims forms and other records to determine insurance coverage.
- Analyze information gathered by investigation and report findings and recommendations.
- Investigate and assess damage to property and create or review property damage estimates.
- Prepare report of findings of investigation.
- Obtain credit information from banks and other credit services.
- Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims.
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- Negotiate claim settlements and recommend litigation when settlement cannot be negotiated.
- 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.
- Refer questionable claims to investigator or claims adjuster for investigation or settlement.
- Examine titles to property to determine validity and act as company agent in transactions with property owners.
Related Technology & Tools
- Desktop computers
- Event data recorders
- Measure markers
- Total stations
- Handheld computers
- Mobile wireless handheld communication devices
- Data collectors
- Field computers
- Personal digital assistants PDA
- Microsoft Word
- Property damage, bodily injury, and liability estimation software
- MapScenes Pro
- PhotoModeler
- Document management system software
- ADP software
- Microsoft Office
- Covansys ClaimConnect
- CAD Zone Insurance
- Bramerhill ClaimsTech
- Magnify Predictive Targeting System
- CSC Colossus
- Injury Sciences EDR InSight
- StrataCare StrataWare eReview
- IBM Fraud and Abuse Management System
- Bridium Claims 3
- Automatic Data Processing Autosource
- Hyland OnBase Enterprise Content Management
- Clear Technology Tranzax
- First Notice Systems ClaimCapture
- ISO NetMap for Claims
- Agency Management Systems AMS 360
- Insurance claims fraud detection software
- CCC GuidePost Decision Support
- CCC TL2000 Solution
- Castek Insure3 Claims
- Axonwave Fraud and Abuse Management System
- Bill review software
- BCCORP Burkitt W5
- 4n6xprt Systems StiffCalcs
- ARSoftware WinSMAC
- ISO ClaimSearch
- CSC Fault Evaluator
- Microsoft Excel
- Autoclaims Direct DirectLink
- MapScenes Evidence Recorder
- Hummingbird Legal Bill Review
- Simsol for Adjusters
- Turtle Creek Software Goldenseal Architect
- Visual Statement Investigator Suite
- Brightwork Alyce Claims Systems
- CSC Automated Work Distributor AWD
- CGI INSideOUT
- Corporate Systems ClaimsPro
- Datanex ClaimTrac
- CCC Pathways Appraisal Quality Solution
- CCC Pathways Image Management Solution
- InSystems Calligo Document Management System
- Automatic Data Processing Estimating
- CGI-AMS BureauLink Enterprise
- Claims processing administration and management software
- LexisNexis RiskWise
- Captiva InputAccel
- CCC EZNet electronic communications network
- Fair Isaac SmartAdvisor
- QwikQuote software
- Automatic Data Processing Claims Manager & Dispatch
- Computerized voice stress analyzer CVSA software