- Description
- Work Activities
- Abilities
- Interests
- Knowledge
- Wages
- Skills
- Work Values
- Work Styles
- Related Degrees
- Work Context
- Task Ratings
- Education
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.
Claims Examiners, Property and Casualty Insurance spend a lot of their time Resolving Conflicts and Negotiating with Others. They are naturally good at Oral Comprehension, Oral Expression, Inductive Reasoning, and Written Comprehension. Claims Examiners, Property and Casualty Insurance are typically characterized as being Conventional and Enterprising. They are usually very knowledgable about Customer and Personal Service, English Language, and Law and Government and are skilled at Reading Comprehension and Critical Thinking.
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Work Activities
Resolving Conflicts and Negotiating with Others
Identifying Objects, Actions, and Events
Getting Information
Organizing, Planning, and Prioritizing Work
Evaluating Information to Determine Compliance with Standards
Communicating with Supervisors, Peers, or Subordinates
Making Decisions and Solving Problems
Monitor Processes, Materials, or Surroundings
Processing Information
Updating and Using Relevant Knowledge
Establishing and Maintaining Interpersonal Relationships
Communicating with Persons Outside Organization
Judging the Qualities of Things, Services, or People
Documenting/Recording Information
Interacting With Computers
Analyzing Data or Information
Performing for or Working Directly with the Public
Thinking Creatively
Monitoring and Controlling Resources
Inspecting Equipment, Structures, or Material
Estimating the Quantifiable Characteristics of Products, Events, or Information
Interpreting the Meaning of Information for Others
Coaching and Developing Others
Developing Objectives and Strategies
Scheduling Work and Activities
Performing Administrative Activities
Coordinating the Work and Activities of Others
Assisting and Caring for Others
Guiding, Directing, and Motivating Subordinates
Training and Teaching Others
Developing and Building Teams
Provide Consultation and Advice to Others
Selling or Influencing Others
Staffing Organizational Units
Handling and Moving Objects
Controlling Machines and Processes
Performing General Physical Activities
Abilities
Oral Comprehension
Oral Expression
Inductive Reasoning
Written Comprehension
Written Expression
Deductive Reasoning
Information Ordering
Problem Sensitivity
Speech Recognition
Near Vision
Category Flexibility
Speech Clarity
Selective Attention
Mathematical Reasoning
Originality
Fluency of Ideas
Flexibility of Closure
Far Vision
Time Sharing
Memorization
Number Facility
Perceptual Speed
Speed of Closure
Visualization
Finger Dexterity
Visual Color Discrimination
Auditory Attention
Hearing Sensitivity
Depth Perception
Arm-Hand Steadiness
Manual Dexterity
Control Precision
Interests
Conventional
Enterprising
Investigative
Realistic
Social
Artistic
Knowledge
Customer and Personal Service
English Language
Law and Government
Administration and Management
Mathematics
Clerical
Computers and Electronics
Education and Training
Building and Construction
Psychology
Communications and Media
Public Safety and Security
Economics and Accounting
Mechanical
Personnel and Human Resources
Transportation
Medicine and Dentistry
Production and Processing
Sociology and Anthropology
Sales and Marketing
Therapy and Counseling
Design
Telecommunications
Philosophy and Theology
Chemistry
Geography
Foreign Language
Physics
Wages
District of Columbia
$74,880
New Jersey
$67,620
California
$65,050
New York
$63,140
Maryland
$62,480
Colorado
$62,410
Alaska
$62,280
Connecticut
$62,170
Massachusetts
$61,650
New Hampshire
$61,580
Oregon
$61,160
Delaware
$61,010
Vermont
$60,420
Louisiana
$60,190
Michigan
$59,580
Nevada
$59,330
Alabama
$59,260
Pennsylvania
$58,940
Washington
$58,700
Illinois
$58,590
North Carolina
$57,480
Mississippi
$57,480
Montana
$57,410
New Mexico
$57,330
Arizona
$56,960
Missouri
$56,910
South Dakota
$56,810
Georgia
$56,490
Texas
$56,380
Ohio
$56,300
Indiana
$56,270
Rhode Island
$55,890
Kentucky
$55,740
West Virginia
$55,730
Wisconsin
$54,850
Tennessee
$54,090
Maine
$53,980
Florida
$53,400
Minnesota
$53,180
Virginia
$52,340
Wyoming
$52,190
Iowa
$51,610
Arkansas
$51,240
South Carolina
$51,130
Kansas
$51,050
Idaho
$50,930
Hawaii
$49,020
Utah
$48,310
Nebraska
$48,070
Oklahoma
$47,450
North Dakota
$47,340
Guam
$37,220
Puerto Rico
$32,340
Skills
Reading Comprehension
Critical Thinking
Active Listening
Speaking
Writing
Negotiation
Judgment and Decision Making
Active Learning
Persuasion
Social Perceptiveness
Service Orientation
Monitoring
Coordination
Complex Problem Solving
Instructing
Learning Strategies
Mathematics
Time Management
Systems Analysis
Systems Evaluation
Management of Personnel Resources
Operation Monitoring
Management of Financial Resources
Quality Control Analysis
Management of Material Resources
Troubleshooting
Programming
Technology Design
Work Values
Support
Independence
Working Conditions
Relationships
Achievement
Recognition
Work Styles
Integrity
Dependability
Attention to Detail
Stress Tolerance
Self Control
Cooperation
Independence
Persistence
Analytical Thinking
Adaptability/Flexibility
Initiative
Concern for Others
Achievement/Effort
Leadership
Innovation
Social Orientation
Related University Degree Programs
Work Context
Telephone
Electronic Mail
Letters and Memos
Importance of Being Exact or Accurate
Contact With Others
Frequency of Decision Making
Impact of Decisions on Co-workers or Company Results
Indoors, Environmentally Controlled
Spend Time Sitting
Frequency of Conflict Situations
Work With Work Group or Team
Face-to-Face Discussions
Deal With External Customers
Freedom to Make Decisions
Spend Time Making Repetitive Motions
Importance of Repeating Same Tasks
Time Pressure
Degree of Automation
Structured versus Unstructured Work
Level of Competition
Coordinate or Lead Others
Sounds, Noise Levels Are Distracting or Uncomfortable
Deal With Unpleasant or Angry People
Physical Proximity
Responsibility for Outcomes and Results
Consequence of Error
Duration of Typical Work Week
Spend Time Using Your Hands to Handle, Control, or Feel Objects, Tools, or Controls
Public Speaking
In an Enclosed Vehicle or Equipment
Spend Time Standing
Outdoors, Exposed to Weather
Indoors, Not Environmentally Controlled
Spend Time Walking and Running
Responsible for Others' Health and Safety
Spend Time Bending or Twisting the Body
Exposed to Hazardous Conditions
Exposed to High Places
Deal With Physically Aggressive People
Very Hot or Cold Temperatures
Exposed to Minor Burns, Cuts, Bites, or Stings
Spend Time Kneeling, Crouching, Stooping, or Crawling
Spend Time Climbing Ladders, Scaffolds, or Poles
Extremely Bright or Inadequate Lighting
Exposed to Hazardous Equipment
Pace Determined by Speed of Equipment
Exposed to Contaminants
Cramped Work Space, Awkward Positions
Work Schedules
Spend Time Keeping or Regaining Balance
Outdoors, Under Cover
Wear Common Protective or Safety Equipment such as Safety Shoes, Glasses, Gloves, Hearing Protection, Hard Hats, or Life Jackets
Exposed to Disease or Infections
Wear Specialized Protective or Safety Equipment such as Breathing Apparatus, Safety Harness, Full Protection Suits, or Radiation Protection
Exposed to Radiation
In an Open Vehicle or Equipment
Exposed to Whole Body Vibration
-40 hours-
Duration of Typical Work Week
-A lot of freedom-
Structured versus Unstructured Work
Freedom to Make Decisions
-About half the time-
Spend Time Standing
Spend Time Sitting
Spend Time Making Repetitive Motions
Spend Time Using Your Hands to Handle, Control, or Feel Objects, Tools, or Controls
Spend Time Kneeling, Crouching, Stooping, or Crawling
Spend Time Climbing Ladders, Scaffolds, or Poles
Spend Time Bending or Twisting the Body
Spend Time Keeping or Regaining Balance
Spend Time Walking and Running
-Completely automated-
Degree of Automation
-Constant contact with others-
Contact With Others
-Contact with others about half the time-
Contact With Others
-Contact with others most of the time-
Contact With Others
-Continually or almost continually-
Spend Time Sitting
Spend Time Making Repetitive Motions
Spend Time Using Your Hands to Handle, Control, or Feel Objects, Tools, or Controls
Spend Time Keeping or Regaining Balance
Spend Time Walking and Running
Spend Time Standing
Spend Time Kneeling, Crouching, Stooping, or Crawling
Spend Time Climbing Ladders, Scaffolds, or Poles
Spend Time Bending or Twisting the Body
-Every day-
Telephone
Electronic Mail
Letters and Memos
Indoors, Environmentally Controlled
Frequency of Decision Making
Frequency of Conflict Situations
Face-to-Face Discussions
Time Pressure
Sounds, Noise Levels Are Distracting or Uncomfortable
In an Enclosed Vehicle or Equipment
Deal With Unpleasant or Angry People
In an Open Vehicle or Equipment
Extremely Bright or Inadequate Lighting
Exposed to Disease or Infections
Wear Specialized Protective or Safety Equipment such as Breathing Apparatus, Safety Harness, Full Protection Suits, or Radiation Protection
Outdoors, Exposed to Weather
Exposed to Whole Body Vibration
Exposed to Hazardous Equipment
Exposed to Contaminants
Exposed to High Places
Outdoors, Under Cover
Very Hot or Cold Temperatures
Exposed to Radiation
Public Speaking
Exposed to Minor Burns, Cuts, Bites, or Stings
Wear Common Protective or Safety Equipment such as Safety Shoes, Glasses, Gloves, Hearing Protection, Hard Hats, or Life Jackets
Indoors, Not Environmentally Controlled
Cramped Work Space, Awkward Positions
Exposed to Hazardous Conditions
Deal With Physically Aggressive People
-Extremely competitive-
Level of Competition
-Extremely important-
Importance of Being Exact or Accurate
Deal With External Customers
Work With Work Group or Team
Coordinate or Lead Others
Importance of Repeating Same Tasks
Pace Determined by Speed of Equipment
-Extremely serious-
Consequence of Error
-Fairly important-
Coordinate or Lead Others
Work With Work Group or Team
Deal With External Customers
Importance of Being Exact or Accurate
Pace Determined by Speed of Equipment
Importance of Repeating Same Tasks
-Fairly serious-
Consequence of Error
-High responsibility-
Responsibility for Outcomes and Results
Responsible for Others' Health and Safety
-Highly automated-
Degree of Automation
-Highly competitive-
Level of Competition
-I don't work near other people (beyond 100 ft.)-
Physical Proximity
-I work with others but not closely (e.g., private office)-
Physical Proximity
-Important-
Coordinate or Lead Others
Deal With External Customers
Importance of Repeating Same Tasks
Work With Work Group or Team
Importance of Being Exact or Accurate
Pace Determined by Speed of Equipment
-Important results-
Impact of Decisions on Co-workers or Company Results
-Irregular (changes with weather conditions, production demands, or contract duration)-
Work Schedules
-Less than 40 hours-
Duration of Typical Work Week
-Less than half the time-
Spend Time Walking and Running
Spend Time Bending or Twisting the Body
Spend Time Standing
Spend Time Climbing Ladders, Scaffolds, or Poles
Spend Time Kneeling, Crouching, Stooping, or Crawling
Spend Time Keeping or Regaining Balance
Spend Time Making Repetitive Motions
Spend Time Using Your Hands to Handle, Control, or Feel Objects, Tools, or Controls
Spend Time Sitting
-Limited freedom-
Structured versus Unstructured Work
Freedom to Make Decisions
-Limited responsibility-
Responsibility for Outcomes and Results
Responsible for Others' Health and Safety
-Minor results-
Impact of Decisions on Co-workers or Company Results
-Moderate responsibility-
Responsibility for Outcomes and Results
Responsible for Others' Health and Safety
-Moderate results-
Impact of Decisions on Co-workers or Company Results
-Moderately automated-
Degree of Automation
-Moderately close (at arm's length)-
Physical Proximity
-Moderately competitive-
Level of Competition
-More than 40 hours-
Duration of Typical Work Week
-More than half the time-
Spend Time Sitting
Spend Time Making Repetitive Motions
Spend Time Standing
Spend Time Bending or Twisting the Body
Spend Time Using Your Hands to Handle, Control, or Feel Objects, Tools, or Controls
Spend Time Walking and Running
Spend Time Kneeling, Crouching, Stooping, or Crawling
Spend Time Climbing Ladders, Scaffolds, or Poles
Spend Time Keeping or Regaining Balance
-Never-
In an Open Vehicle or Equipment
Exposed to Whole Body Vibration
Exposed to Radiation
Exposed to Disease or Infections
Wear Specialized Protective or Safety Equipment such as Breathing Apparatus, Safety Harness, Full Protection Suits, or Radiation Protection
Wear Common Protective or Safety Equipment such as Safety Shoes, Glasses, Gloves, Hearing Protection, Hard Hats, or Life Jackets
Outdoors, Under Cover
Cramped Work Space, Awkward Positions
Spend Time Keeping or Regaining Balance
Very Hot or Cold Temperatures
Extremely Bright or Inadequate Lighting
Exposed to Contaminants
Exposed to Minor Burns, Cuts, Bites, or Stings
Spend Time Kneeling, Crouching, Stooping, or Crawling
Exposed to Hazardous Equipment
Exposed to High Places
Spend Time Climbing Ladders, Scaffolds, or Poles
Exposed to Hazardous Conditions
Deal With Physically Aggressive People
Spend Time Using Your Hands to Handle, Control, or Feel Objects, Tools, or Controls
Indoors, Not Environmentally Controlled
Outdoors, Exposed to Weather
Spend Time Bending or Twisting the Body
In an Enclosed Vehicle or Equipment
Spend Time Standing
Spend Time Walking and Running
Public Speaking
Indoors, Environmentally Controlled
Frequency of Conflict Situations
Sounds, Noise Levels Are Distracting or Uncomfortable
Spend Time Making Repetitive Motions
Time Pressure
Telephone
Spend Time Sitting
Face-to-Face Discussions
Frequency of Decision Making
Electronic Mail
Deal With Unpleasant or Angry People
Letters and Memos
-No contact with others-
Contact With Others
-No freedom-
Structured versus Unstructured Work
Freedom to Make Decisions
-No responsibility-
Responsible for Others' Health and Safety
Responsibility for Outcomes and Results
-No results-
Impact of Decisions on Co-workers or Company Results
-Not at all automated-
Degree of Automation
-Not at all competitive-
Level of Competition
-Not important at all-
Pace Determined by Speed of Equipment
Coordinate or Lead Others
Deal With External Customers
Importance of Repeating Same Tasks
Work With Work Group or Team
Importance of Being Exact or Accurate
-Not serious at all-
Consequence of Error
-Occasional contact with others-
Contact With Others
-Once a month or more but not every week-
Public Speaking
Deal With Unpleasant or Angry People
In an Enclosed Vehicle or Equipment
Exposed to High Places
Exposed to Hazardous Conditions
Sounds, Noise Levels Are Distracting or Uncomfortable
Indoors, Not Environmentally Controlled
Very Hot or Cold Temperatures
Face-to-Face Discussions
Extremely Bright or Inadequate Lighting
Frequency of Conflict Situations
Time Pressure
Outdoors, Under Cover
Outdoors, Exposed to Weather
Exposed to Contaminants
Electronic Mail
Exposed to Radiation
Exposed to Minor Burns, Cuts, Bites, or Stings
Wear Common Protective or Safety Equipment such as Safety Shoes, Glasses, Gloves, Hearing Protection, Hard Hats, or Life Jackets
Cramped Work Space, Awkward Positions
Letters and Memos
Deal With Physically Aggressive People
In an Open Vehicle or Equipment
Exposed to Disease or Infections
Telephone
Wear Specialized Protective or Safety Equipment such as Breathing Apparatus, Safety Harness, Full Protection Suits, or Radiation Protection
Exposed to Whole Body Vibration
Exposed to Hazardous Equipment
Indoors, Environmentally Controlled
Frequency of Decision Making
-Once a week or more but not every day-
Deal With Unpleasant or Angry People
Sounds, Noise Levels Are Distracting or Uncomfortable
Face-to-Face Discussions
Frequency of Decision Making
Outdoors, Exposed to Weather
Frequency of Conflict Situations
Time Pressure
Public Speaking
Indoors, Not Environmentally Controlled
Cramped Work Space, Awkward Positions
Letters and Memos
Electronic Mail
Outdoors, Under Cover
Very Hot or Cold Temperatures
Exposed to Minor Burns, Cuts, Bites, or Stings
Wear Common Protective or Safety Equipment such as Safety Shoes, Glasses, Gloves, Hearing Protection, Hard Hats, or Life Jackets
Exposed to Hazardous Conditions
Deal With Physically Aggressive People
In an Open Vehicle or Equipment
Extremely Bright or Inadequate Lighting
Exposed to Disease or Infections
Telephone
Wear Specialized Protective or Safety Equipment such as Breathing Apparatus, Safety Harness, Full Protection Suits, or Radiation Protection
Exposed to Whole Body Vibration
Exposed to Hazardous Equipment
Indoors, Environmentally Controlled
In an Enclosed Vehicle or Equipment
Exposed to Contaminants
Exposed to High Places
Exposed to Radiation
-Once a year or more but not every month-
Deal With Physically Aggressive People
Exposed to Hazardous Equipment
Outdoors, Exposed to Weather
Exposed to Minor Burns, Cuts, Bites, or Stings
In an Enclosed Vehicle or Equipment
Exposed to Contaminants
Indoors, Not Environmentally Controlled
Public Speaking
Time Pressure
Sounds, Noise Levels Are Distracting or Uncomfortable
Extremely Bright or Inadequate Lighting
Outdoors, Under Cover
Cramped Work Space, Awkward Positions
Exposed to Hazardous Conditions
Wear Common Protective or Safety Equipment such as Safety Shoes, Glasses, Gloves, Hearing Protection, Hard Hats, or Life Jackets
Exposed to High Places
Very Hot or Cold Temperatures
Exposed to Disease or Infections
Wear Specialized Protective or Safety Equipment such as Breathing Apparatus, Safety Harness, Full Protection Suits, or Radiation Protection
Deal With Unpleasant or Angry People
Face-to-Face Discussions
Exposed to Whole Body Vibration
Frequency of Decision Making
Indoors, Environmentally Controlled
Electronic Mail
Exposed to Radiation
Letters and Memos
In an Open Vehicle or Equipment
Telephone
Frequency of Conflict Situations
-Regular (established routine, set schedule)-
Work Schedules
-Seasonal (only during certain times of the year)-
Work Schedules
-Serious-
Consequence of Error
-Slightly automated-
Degree of Automation
-Slightly close (e.g., shared office)-
Physical Proximity
-Slightly competitive-
Level of Competition
-Some freedom-
Freedom to Make Decisions
Structured versus Unstructured Work
-Very close (near touching)-
Physical Proximity
-Very high responsibility-
Responsibility for Outcomes and Results
Responsible for Others' Health and Safety
-Very important-
Importance of Repeating Same Tasks
Work With Work Group or Team
Importance of Being Exact or Accurate
Pace Determined by Speed of Equipment
Coordinate or Lead Others
Deal With External Customers
-Very important results-
Impact of Decisions on Co-workers or Company Results
-Very little freedom-
Structured versus Unstructured Work
Freedom to Make Decisions
-Very serious-
Consequence of Error
Task Ratings
- Importance Core-
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.
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
Resolve complex, severe exposure claims, using high service oriented file handling.
Pay and process claims within designated authority level.
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
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.
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Confer with legal counsel on claims requiring litigation.
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
Present cases and participate in their discussion at claim committee meetings.
- Importance Supplemental-
Supervise claims adjusters to ensure that adjusters have followed proper methods.
Conduct detailed bill reviews to implement sound litigation management and expense control.
Report overpayments, underpayments, and other irregularities.
Communicate with reinsurance brokers to obtain information necessary for processing claims.
Prepare reports to be submitted to company's data processing department.
- Relevance of Task Core-
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.
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
Confer with legal counsel on claims requiring litigation.
Resolve complex, severe exposure claims, using high service oriented file handling.
Pay and process claims within designated authority level.
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Present cases and participate in their discussion at claim committee meetings.
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.
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
- Relevance of Task Supplemental-
Conduct detailed bill reviews to implement sound litigation management and expense control.
Report overpayments, underpayments, and other irregularities.
Communicate with reinsurance brokers to obtain information necessary for processing claims.
Prepare reports to be submitted to company's data processing department.
Supervise claims adjusters to ensure that adjusters have followed proper methods.
-Daily Frequency of Task (Categories 1-7) Core-
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
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.
Pay and process claims within designated authority level.
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
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.
Resolve complex, severe exposure claims, using high service oriented file handling.
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
Confer with legal counsel on claims requiring litigation.
Present cases and participate in their discussion at claim committee meetings.
-Daily Frequency of Task (Categories 1-7) Supplemental-
Conduct detailed bill reviews to implement sound litigation management and expense control.
Supervise claims adjusters to ensure that adjusters have followed proper methods.
Prepare reports to be submitted to company's data processing department.
Report overpayments, underpayments, and other irregularities.
Communicate with reinsurance brokers to obtain information necessary for processing claims.
-Hourly or more Frequency of Task (Categories 1-7) Core-
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.
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
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.
Confer with legal counsel on claims requiring litigation.
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
Pay and process claims within designated authority level.
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
Resolve complex, severe exposure claims, using high service oriented file handling.
Present cases and participate in their discussion at claim committee meetings.
-Hourly or more Frequency of Task (Categories 1-7) Supplemental-
Supervise claims adjusters to ensure that adjusters have followed proper methods.
Report overpayments, underpayments, and other irregularities.
Communicate with reinsurance brokers to obtain information necessary for processing claims.
Conduct detailed bill reviews to implement sound litigation management and expense control.
Prepare reports to be submitted to company's data processing department.
-More than monthly Frequency of Task (Categories 1-7) Core-
Present cases and participate in their discussion at claim committee meetings.
Resolve complex, severe exposure claims, using high service oriented file handling.
Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
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.
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Pay and process claims within designated authority level.
Confer with legal counsel on claims requiring litigation.
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.
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
-More than monthly Frequency of Task (Categories 1-7) Supplemental-
Communicate with reinsurance brokers to obtain information necessary for processing claims.
Report overpayments, underpayments, and other irregularities.
Conduct detailed bill reviews to implement sound litigation management and expense control.
Prepare reports to be submitted to company's data processing department.
Supervise claims adjusters to ensure that adjusters have followed proper methods.
-More than weekly Frequency of Task (Categories 1-7) Core-
Present cases and participate in their discussion at claim committee meetings.
Confer with legal counsel on claims requiring litigation.
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
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.
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
Pay and process claims within designated authority level.
Resolve complex, severe exposure claims, using high service oriented file handling.
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
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.
-More than weekly Frequency of Task (Categories 1-7) Supplemental-
Prepare reports to be submitted to company's data processing department.
Communicate with reinsurance brokers to obtain information necessary for processing claims.
Conduct detailed bill reviews to implement sound litigation management and expense control.
Supervise claims adjusters to ensure that adjusters have followed proper methods.
Report overpayments, underpayments, and other irregularities.
-More than yearly Frequency of Task (Categories 1-7) Core-
Present cases and participate in their discussion at claim committee meetings.
Resolve complex, severe exposure claims, using high service oriented file handling.
Confer with legal counsel on claims requiring litigation.
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
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.
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Pay and process claims within designated authority level.
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.
-More than yearly Frequency of Task (Categories 1-7) Supplemental-
Report overpayments, underpayments, and other irregularities.
Communicate with reinsurance brokers to obtain information necessary for processing claims.
Prepare reports to be submitted to company's data processing department.
Supervise claims adjusters to ensure that adjusters have followed proper methods.
Conduct detailed bill reviews to implement sound litigation management and expense control.
-Several times daily Frequency of Task (Categories 1-7) Core-
Pay and process claims within designated authority level.
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
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.
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.
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
Resolve complex, severe exposure claims, using high service oriented file handling.
Confer with legal counsel on claims requiring litigation.
Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
Present cases and participate in their discussion at claim committee meetings.
-Several times daily Frequency of Task (Categories 1-7) Supplemental-
Supervise claims adjusters to ensure that adjusters have followed proper methods.
Conduct detailed bill reviews to implement sound litigation management and expense control.
Prepare reports to be submitted to company's data processing department.
Communicate with reinsurance brokers to obtain information necessary for processing claims.
Report overpayments, underpayments, and other irregularities.
-Yearly or less Frequency of Task (Categories 1-7) Core-
Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
Present cases and participate in their discussion at claim committee meetings.
Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
Confer with legal counsel on claims requiring litigation.
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.
Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
Resolve complex, severe exposure claims, using high service oriented file handling.
Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
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.
Pay and process claims within designated authority level.
-Yearly or less Frequency of Task (Categories 1-7) Supplemental-
Communicate with reinsurance brokers to obtain information necessary for processing claims.
Report overpayments, underpayments, and other irregularities.
Prepare reports to be submitted to company's data processing department.
Conduct detailed bill reviews to implement sound litigation management and expense control.
Supervise claims adjusters to ensure that adjusters have followed proper methods.
Education Training Experience
-On-Site or In-Plant Training-
None
Up to and including 1 month
Over 1 month, up to and including 3 months
Over 3 months, up to and including 6 months
Over 6 months, up to and including 1 year
Over 1 year, up to and including 2 years
Over 2 years, up to and including 4 years
Over 10 years
-On-the-Job Training-
None or short demonstration
Anything beyond short demonstration, up to and including 1 month
Over 1 month, up to and including 3 months
Over 3 months, up to and including 6 months
Over 6 months, up to and including 1 year
Over 1 year, up to and including 2 years
Over 2 years, up to and including 4 years
Over 4 years, up to and including 10 years
Over 10 years
-Related Work Experience-
None
Over 6 months, up to and including 1 year
Over 1 year, up to and including 2 years
Over 2 years, up to and including 4 years
Over 4 years, up to and including 6 years
Over 6 years, up to and including 8 years
Over 8 years, up to and including 10 years
Over 10 years
-Required Level of Education-
High School Diploma (or GED or High School Equivalence Certificate)
Post-Secondary Certificate - awarded for training completed after high school (for example, in Personnel Services, Engineering-related Technologies, Vocational Home Economics, Construction Trades, Mechanics and Repairers, Precision Production Trades)
Some College Courses
Associate's Degree (or other 2-year degree)
Bachelor's Degree