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Daily Tasks
| Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies. | | Communicate with reinsurance brokers to obtain information necessary for processing claims. | | Conduct detailed bill reviews to implement sound litigation management and expense control. | | Confer with legal counsel on claims requiring litigation. | | Contact or interview claimants, doctors, medical specialists, or employers to get additional information. | | 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. | | 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. | | Prepare reports to be submitted to company's data processing department. | | Present cases and participate in their discussion at claim committee meetings. | | Report overpayments, underpayments, and other irregularities. | | Resolve complex, severe exposure claims, using high service oriented file handling. | | 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. |
Daily Work Activities
| Follow contract, property, or insurance laws. | | Use interviewing procedures. | | Communicate technical information. | | Develop management control systems. | | Investigate insurance claims. | | Maintain records, reports, or files. | | Prepare reports. | | Recommend claim action. | | Use computers to enter, access or retrieve data. | | Use knowledge of investigation techniques. | | Make presentations. | | Verify investigative information. | | Review data on insurance applications or policies. | | Obtain information from individuals. | | Maintain insurance records. | | Note discrepancies in financial records. | | Direct and coordinate activities of workers or staff. | | Compile information through interviews. | | Examine documents for completeness, accuracy, or conformance to standards. | | Confer with prosecuting attorney. |
Other Work Activities
| Analyzing Data or Information | Identifying the underlying principles, reasons, or facts of information by breaking down information or data into separate parts. | | Communicating with Persons Outside Organization | Communicating with people outside the organization, representing the organization to customers, the public, government, and other external sources. This information can be exchanged in person, in writing, or by telephone or e-mail. | | Communicating with Supervisors, Peers, or Subordinates | Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person. | | Documenting/Recording Information | Entering, transcribing, recording, storing, or maintaining information in written or electronic/magnetic form. | | Establishing and Maintaining Interpersonal Relationships | Developing constructive and cooperative working relationships with others, and maintaining them over time. | | Evaluating Information to Determine Compliance with Standards | Using relevant information and individual judgment to determine whether events or processes comply with laws, regulations, or standards. | | Getting Information | Observing, receiving, and otherwise obtaining information from all relevant sources. | | Identifying Objects, Actions, and Events | Identifying information by categorizing, estimating, recognizing differences or similarities, and detecting changes in circumstances or events. | | Interacting With Computers | Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information. | | Making Decisions and Solving Problems | Analyzing information and evaluating results to choose the best solution and solve problems. | | Organizing, Planning, and Prioritizing Work | Developing specific goals and plans to prioritize, organize, and accomplish your work. | | Performing Administrative Activities | Performing day-to-day administrative tasks such as maintaining information files and processing paperwork. | | Processing Information | Compiling, coding, categorizing, calculating, tabulating, auditing, or verifying information or data. | | Resolving Conflicts and Negotiating with Others | Handling complaints, settling disputes, and resolving grievances and conflicts, or otherwise negotiating with others. | | Updating and Using Relevant Knowledge | Keeping up-to-date technically and applying new knowledge to your job. |
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Schools Offering Degrees for
Claims Examiners, Property and Casualty Insurance |
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Career
Assessment
Want to take a fresh look at which careers best fit your skills and interests? Wonder if your current career is a good fit for you,
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