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20 jobs that use Insurance Claims the most

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Jobs that use insurance claims the most include material damage adjuster, surveillance investigator, and insurance investigator.

What jobs use Insurance Claims the most?

1. Material Damage Adjuster

How material damage adjuster uses Insurance Claims:

  • Apply strong customer service, organizational and multitasking skills to efficiently manage auto insurance claims.
  • Review files for SIU investigations for all fire and theft losses.
  • Resolve total loss claims using CCC evaluations for market evaluation of vehicles.

Most common skills for material damage adjuster:

  • Insurance Claims
  • Policy Coverage
  • Repair Estimates
  • ISO
  • Customer Service
  • Police Reports

2. Surveillance Investigator

How surveillance investigator uses Insurance Claims:

  • Save video clips from incidents and procedurals.
  • Investigate SIU claims, conduct covert surveillance and produce reports for possible insurance fraud.
  • Coordinate the design and development of new AML monitoring scenario rules, testing and implementation.

Most common skills for surveillance investigator:

  • Surveillance Video
  • Video Evidence
  • Insurance Claims
  • Conduct Surveillance
  • Criminal Justice
  • SIU

3. Insurance Investigator

How insurance investigator uses Insurance Claims:

  • Manage and dispose of claims in litigation by preparing and developing strategy with defense counsel and consensus relative to litigation handling.
  • Research commercial coverage plans and government plans such as Medicare and Medicaid.
  • Follow all HIPPA guidelines and procedures to protect patients and company interest.

Most common skills for insurance investigator:

  • Insurance Claims
  • Insurance Benefits
  • General Liability
  • Scene Investigations
  • Insurance Laws
  • Consumer Complaints

4. Claims Service Representative

How claims service representative uses Insurance Claims:

  • Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
  • Experience in medical terminology, ICD9, CPT and DRG coding.
  • Review types of service on claims base on the CPT codes and diagnosis code.

Most common skills for claims service representative:

  • Insurance Claims
  • Customer Service
  • Policy Coverage
  • Phone Calls
  • Claims Process
  • Inbound Calls

5. Shop Estimator

How shop estimator uses Insurance Claims:

  • Manage the estimating of a commercial & industrial plumbing and mechanical contracting business.
  • Report potential fraudulent claims to SIU.
  • Maintain excellent customer rapport and high CSI scores.

Most common skills for shop estimator:

  • Insurance Adjusters
  • Customer Satisfaction
  • Management System
  • Insurance Claims
  • CCC
  • Vehicle Damage

6. Liability Claims Manager

How liability claims manager uses Insurance Claims:

  • Manage and develop a mix liability team of litigation, attorney represent and direct or field representatives.
  • Spearhead a team of professionals train to eliminate need for litigation and regulate expenditures.
  • Mentore less experience and newer employees in career development and individual development plans to facilitate future leadership candidates for the enterprise.

Most common skills for liability claims manager:

  • Litigation
  • Claims Management
  • Insurance Claims
  • Mediation
  • Claims Process
  • Claims Handling

7. Claim Investigator

How claim investigator uses Insurance Claims:

  • Manage and dispose of claims in litigation by preparing and developing strategy with defense counsel and consensus relative to litigation handling.
  • Coordinate with SIU investigators in their investigations of the same claimant or insure.
  • Collaborate with SIU, fire, and police personnel in an effort to resolve investigations.

Most common skills for claim investigator:

  • Scene Investigations
  • Insurance Claims
  • Property Damage
  • Fraud Claims
  • Background Checks
  • Litigation

8. Auto Claims Adjuster

How auto claims adjuster uses Insurance Claims:

  • Manage file inventory by utilizing CCC pathways diary system documenting claim file activities in accordance with establish procedures
  • Work closely with staff attorneys to develop litigation strategies and prepare for depositions.
  • Provide feedback and implement strategies on claim investigation, reserving, settlement and litigation.

Most common skills for auto claims adjuster:

  • Repair Process
  • Body Shop
  • Strong Customer Service
  • Vehicle Inspections
  • Insurance Claims
  • Customer Service

9. Social Insurance Administrator

How social insurance administrator uses Insurance Claims:

  • Cold-Cal to generate leads for individual life and disability insurance and annuities.
  • Resolve issues that arise concerning private insurance and Medicaid claims and collections.
  • Assist patients by updating and correcting statement errors, and annotate additional billing information request on the behalf of insurance company.

Most common skills for social insurance administrator:

  • Patients
  • Insurance Policies
  • Insurance Benefits
  • Insurance Claims
  • Medical Necessity
  • Life Insurance

10. Claim Processing Specialist

How claim processing specialist uses Insurance Claims:

  • Manage expedition of appeals via problem solving and collaboration with other departments.
  • Provide consumer-oriented health benefit plans, process all types of health claims knowledgeable of ICD-9 and CPT codes.
  • Process medical claims for Medicaid recipients via a state-fund Medicaid insurance carrier per plan guidelines and department procedures.

Most common skills for claim processing specialist:

  • Data Entry
  • Process Claims
  • Insurance Claims
  • Inbound Calls
  • CPT
  • Medicaid

11. Claims Associate

How claims associate uses Insurance Claims:

  • Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
  • Obtain vehicle information from the DMV.
  • Follow HIPAA policy on each and every call.

Most common skills for claims associate:

  • Customer Service
  • Medical Claims
  • Phone Calls
  • Claims Handling
  • Insurance Claims
  • Medical Terminology

12. Claims Resolution Specialist

How claims resolution specialist uses Insurance Claims:

  • Manage expedition of appeals via problem solving and collaboration with other departments.
  • Assist provider with ICD-9, CPT and revenue codes, DME, coordination of benefits, efficiently train on HIPPA.
  • Process medical claims submit to Kansas Medicaid using establish guidelines and policies.

Most common skills for claims resolution specialist:

  • Patients
  • Medical Terminology
  • Insurance Claims
  • Patient Accounts
  • Medicaid
  • CPT

13. Insurance Processor

How insurance processor uses Insurance Claims:

  • Manage database by processing renewals and endorsements.
  • Input and process all dental claims, through electronic and paper submission, to private insurance companies and Medicaid.
  • Maintain patient privacy and confidentiality complaint with HIPPA regulations.

Most common skills for insurance processor:

  • Data Entry
  • Customer Service
  • Phone Calls
  • Outbound Calls
  • Insurance Claims
  • Insurance Coverage

14. Liability Claims Representative

How liability claims representative uses Insurance Claims:

  • Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
  • Investigate and conclude property and casualty liability claims including those in litigation with the highest overall production of the claims representatives.
  • Participate in arbitration hearings through writing contentions, compiling evidence and personally representing files.

Most common skills for liability claims representative:

  • Litigation
  • Claims Handling
  • Customer Service
  • Law Enforcement Agencies
  • Insurance Claims
  • Reservations

15. Claims Reviewer

How claims reviewer uses Insurance Claims:

  • Manage day-to-day operations of claims department and provide general oversight and direction of all claims activity.
  • Review worker comp claims base on state fee schedule and ICD-9 guidelines.
  • Research ICD-9 codes and verify they are equivalent with customer s diagnoses.

Most common skills for claims reviewer:

  • Home Health
  • Insurance Claims
  • Data Entry
  • Medical Terminology
  • CPT
  • Claims Submission

16. Claims Assistant

How claims assistant uses Insurance Claims:

  • Manage adding and removing vendors through claims automate system to ensure they are in compliance with IRS regulations.
  • Process all HMO member reimbursements.
  • Create and provide weekly/monthly reports and PowerPoint presentations.

Most common skills for claims assistant:

  • Customer Service
  • Data Entry
  • Photocopying
  • Insurance Claims
  • Insurance Adjusters
  • Veterans

17. Special Investigator

How special investigator uses Insurance Claims:

  • Gather and analyze pertinent documentation, collect recorded statements, report fraud, and manage data in support of subsequent litigation.
  • Gather and analyze pertinent documentation, collect recorded statements, report fraud, and manage data in support of subsequent litigation.
  • Complete a DMV check to verify applicant identity.

Most common skills for special investigator:

  • Law Enforcement Agencies
  • Background Checks
  • Child Abuse
  • Insurance Claims
  • SIS
  • Local Law Enforcement

18. Claims Coordinator

How claims coordinator uses Insurance Claims:

  • Investigate, evaluate, and manage call to complete coverage analysis confirming or denying coverage using Xactimate estimating software.
  • Process and adjust Medicare claims, provide feedback to providers on proper CPT, ICD-9 coding for billing purposes.
  • Serve as point of contact for all legal issues relate to HIPAA.

Most common skills for claims coordinator:

  • Customer Service
  • Patients
  • Data Entry
  • Phone Calls
  • Insurance Claims
  • Quality Standards

19. Total Loss Specialist

How total loss specialist uses Insurance Claims:

  • Analyze and support development and execution of underwriting, automation and operational strategies to efficiently and effectively manage the portfolio.
  • Work with SIU to flag fraud and mitigate fraudulent payouts.
  • Clean, pack and organize the SIU office and files.

Most common skills for total loss specialist:

  • Customer Service
  • HR
  • Outbound Calls
  • Inbound Calls
  • Insurance Claims
  • Training Sessions

20. Senior Claims Representative

How senior claims representative uses Insurance Claims:

  • Conduct detailed interviews with physicians, prepare comprehensive written reports, retain defense counsel, and effectively manage the litigation process.
  • Utilize Xactimate estimating system during field inspection to properly evaluate commercial property damages.
  • Update computer generate claim file (s) with medical diagnoses, current CPT and ICD codes.

Most common skills for senior claims representative:

  • Customer Service
  • Claims Handling
  • Litigation
  • Insurance Claims
  • Bodily Injury Claims
  • Automobile Claims

Other skills

Updated December 28, 2023