The document describes various roles in the insurance claims department. Claims adjusters investigate and evaluate insurance claims to determine liability and negotiate settlements. Claims examiners review claims to ensure validity and compliance. Claims managers oversee the claims department and set policies and procedures. Specialists handle specific types of claims like auto, medical, workers' compensation, or investigate fraud. Other roles provide support through customer service, training, auditing, analyzing data, and managing catastrophic event response.
The document describes various roles in the insurance claims department. Claims adjusters investigate and evaluate insurance claims to determine liability and negotiate settlements. Claims examiners review claims to ensure validity and compliance. Claims managers oversee the claims department and set policies and procedures. Specialists handle specific types of claims like auto, medical, workers' compensation, or investigate fraud. Other roles provide support through customer service, training, auditing, analyzing data, and managing catastrophic event response.
The document describes various roles in the insurance claims department. Claims adjusters investigate and evaluate insurance claims to determine liability and negotiate settlements. Claims examiners review claims to ensure validity and compliance. Claims managers oversee the claims department and set policies and procedures. Specialists handle specific types of claims like auto, medical, workers' compensation, or investigate fraud. Other roles provide support through customer service, training, auditing, analyzing data, and managing catastrophic event response.
Claims Adjuster: Investigates and evaluates insurance claims to determine the
extent of the insurance company's liability and negotiate settlements with claimants. 2. Claims Examiner: Reviews claims to ensure that they are valid and comply with the terms and conditions of the policy. They may also work with claims adjusters to provide support and guidance. 3. Claims Manager: Oversees the claims department and is responsible for managing the team of claims adjusters and examiners. They may also be responsible for setting policies and procedures for claims handling and ensuring compliance with industry regulations. 4. Subrogation Specialist: Investigates claims where the insurance company may be able to recover costs from a third party and pursues subrogation claims on behalf of the insurance company. 5. Claims Analyst: Analyzes claims data to identify trends and patterns, and provides insights to support decision-making in the claims department. 6. Claims Support Staff: Provides administrative and technical support to the claims department, such as data entry, record keeping, and customer service. 7. Catastrophe Claims Adjuster: Responds to claims resulting from natural disasters, such as hurricanes or floods. 8. Medical Claims Specialist: Reviews and processes claims related to healthcare services, including medical treatments, surgeries, and medications. 9. Auto Claims Specialist: Handles claims related to auto accidents, including property damage and bodily injury claims. 10. Workers' Compensation Claims Specialist: Handles claims related to workplace injuries or illnesses, including medical treatment and wage replacement benefits. 11. Property Claims Adjuster: Investigates and evaluates claims related to property damage or loss, such as from fires or thefts. 12. Liability Claims Adjuster: Investigates and evaluates claims related to liability, such as from accidents or injuries caused by another person. 13. Fraud Investigator: Investigates suspicious claims and works to prevent fraudulent activity within the claims department. 14. Salvage and Recovery Specialist: Identifies opportunities to recover or salvage damaged or stolen property and coordinates the recovery process. 15. Catastrophe Response Manager: Oversees the claims handling process during and after natural disasters or other catastrophic events. 16. Customer Service Representative: Communicates with customers to answer questions, provide updates, and resolve issues related to their claims. 17. Claims Auditor: Audits claims files to ensure compliance with industry regulations and company policies. 18. Claims Trainer: Trains new claims staff on policies, procedures, and best practices for claims handling. 19. Quality Assurance Analyst: Monitors and evaluates the quality of claims handling and provides feedback and recommendations for improvement. 20. Litigation Specialist: Works with legal counsel to handle claims that have escalated to litigation, including providing information and documentation and appearing in court as needed. 21. Catastrophe Response Coordinator: Coordinates the response efforts of the claims department during and after natural disasters or other catastrophic events. 22. Catastrophe Claims Examiner: Works with the Catastrophe Response Manager and Catastrophe Claims Adjusters to ensure that claims are processed efficiently and effectively in response to a natural disaster. 23. Claims Data Analyst: Analyzes claims data to identify areas for improvement in claims handling processes, policies, and procedures. 24. Senior Claims Adjuster: Handles complex claims that require specialized knowledge and experience, and may provide guidance and mentorship to other claims adjusters. 25. Claims Escalation Specialist: Handles claims that have been escalated by customers or other employees and works to resolve the issue in a timely and efficient manner. 26. Claims Investigator: Conducts investigations into claims to determine their validity and potential for fraud or misrepresentation.