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Claims Examiners, Property and Casualty Insurance

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.

Tasks

Knowledge

English Language
Knowledge of the structure and content of the English language including the meaning and spelling of words, rules of composition, and grammar.
Customer and Personal Service
Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.
Law and Government
Knowledge of laws, legal codes, court procedures, precedents, government regulations, executive orders, agency rules, and the democratic political process.
Clerical
Knowledge of administrative and clerical procedures and systems such as word processing, managing files and records, stenography and transcription, designing forms, and other office procedures and terminology.
Mathematics
Knowledge of arithmetic, algebra, geometry, calculus, statistics, and their applications.
Computers and Electronics
Knowledge of circuit boards, processors, chips, electronic equipment, and computer hardware and software, including applications and programming.
Medicine and Dentistry
Knowledge of the information and techniques needed to diagnose and treat human injuries, diseases, and deformities. This includes symptoms, treatment alternatives, drug properties and interactions, and preventive health-care measures.
Administration and Management
Knowledge of business and management principles involved in strategic planning, resource allocation, human resources modeling, leadership technique, production methods, and coordination of people and resources.
Economics and Accounting
Knowledge of economic and accounting principles and practices, the financial markets, banking and the analysis and reporting of financial data.
Telecommunications
Knowledge of transmission, broadcasting, switching, control, and operation of telecommunications systems.

Skills

Reading Comprehension
Understanding written sentences and paragraphs in work related documents.
Judgment and Decision Making
Considering the relative costs and benefits of potential actions to choose the most appropriate one.
Active Listening
Giving full attention to what other people are saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
Writing
Communicating effectively in writing as appropriate for the needs of the audience.
Time Management
Managing one's own time and the time of others.
Critical Thinking
Using logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
Speaking
Talking to others to convey information effectively.
Active Learning
Understanding the implications of new information for both current and future problem-solving and decision-making.
Negotiation
Bringing others together and trying to reconcile differences.
Complex Problem Solving
Identifying complex problems and reviewing related information to develop and evaluate options and implement solutions.

Abilities

Oral Comprehension
The ability to listen to and understand information and ideas presented through spoken words and sentences.
Oral Expression
The ability to communicate information and ideas in speaking so others will understand.
Deductive Reasoning
The ability to apply general rules to specific problems to produce answers that make sense.
Written Comprehension
The ability to read and understand information and ideas presented in writing.
Problem Sensitivity
The ability to tell when something is wrong or is likely to go wrong. It does not involve solving the problem, only recognizing there is a problem.
Inductive Reasoning
The ability to combine pieces of information to form general rules or conclusions (includes finding a relationship among seemingly unrelated events).
Speech Recognition
The ability to identify and understand the speech of another person.
Speech Clarity
The ability to speak clearly so others can understand you.
Information Ordering
The ability to arrange things or actions in a certain order or pattern according to a specific rule or set of rules (e.g., patterns of numbers, letters, words, pictures, mathematical operations).
Near Vision
The ability to see details at close range (within a few feet of the observer).

Work Activities

Getting Information
Observing, receiving, and otherwise obtaining information from all relevant sources.
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.
Interacting With Computers
Using computers and computer systems (including hardware and software) to program, write software, set up functions, enter data, or process information.
Documenting/Recording Information
Entering, transcribing, recording, storing, or maintaining information in written or electronic/magnetic form.
Communicating with Supervisors, Peers, or Subordinates
Providing information to supervisors, co-workers, and subordinates by telephone, in written form, e-mail, or in person.
Making Decisions and Solving Problems
Analyzing information and evaluating results to choose the best solution and solve problems.
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.
Performing Administrative Activities
Performing day-to-day administrative tasks such as maintaining information files and processing paperwork.
Interpreting the Meaning of Information for Others
Translating or explaining what information means and how it can be used.

Work Context

Structured versus Unstructured Work
To what extent is this job structured for the worker, rather than allowing the worker to determine tasks, priorities, and goals?
Indoors, Environmentally Controlled
How often does this job require working indoors in environmentally controlled conditions?
Spend Time Sitting
How much does this job require sitting?
Face-to-Face Discussions
How often do you have to have face-to-face discussions with individuals or teams in this job?
Importance of Being Exact or Accurate
How important is being very exact or highly accurate in performing this job?
Contact With Others
How much does this job require the worker to be in contact with others (face-to-face, by telephone, or otherwise) in order to perform it?
Telephone
How often do you have telephone conversations in this job?
Freedom to Make Decisions
How much decision making freedom, without supervision, does the job offer?
Time Pressure
How often does this job require the worker to meet strict deadlines?
Frequency of Decision Making
How frequently is the worker required to make decisions that affect other people, the financial resources, and/or the image and reputation of the organization?

Interests

Conventional
Conventional occupations frequently involve following set procedures and routines. These occupations can include working with data and details more than with ideas. Usually there is a clear line of authority to follow.
Enterprising
Enterprising occupations frequently involve starting up and carrying out projects. These occupations can involve leading people and making many decisions. Sometimes they require risk taking and often deal with business.
Investigative
Investigative occupations frequently involve working with ideas, and require an extensive amount of thinking. These occupations can involve searching for facts and figuring out problems mentally.
Realistic
Realistic occupations frequently involve work activities that include practical, hands-on problems and solutions. They often deal with plants, animals, and real-world materials like wood, tools, and machinery. Many of the occupations require working outside, and do not involve a lot of paperwork or working closely with others.
Social
Social occupations frequently involve working with, communicating with, and teaching people. These occupations often involve helping or providing service to others.
Artistic
Artistic occupations frequently involve working with forms, designs and patterns. They often require self-expression and the work can be done without following a clear set of rules.

Work Style

Dependability
Job requires being reliable, responsible, and dependable, and fulfilling obligations.
Attention to Detail
Job requires being careful about detail and thorough in completing work tasks.
Integrity
Job requires being honest and ethical.
Analytical Thinking
Job requires analyzing information and using logic to address work-related issues and problems.
Adaptability/Flexibility
Job requires being open to change (positive or negative) and to considerable variety in the workplace.
Stress Tolerance
Job requires accepting criticism and dealing calmly and effectively with high stress situations.
Cooperation
Job requires being pleasant with others on the job and displaying a good-natured, cooperative attitude.
Initiative
Job requires a willingness to take on responsibilities and challenges.
Self Control
Job requires maintaining composure, keeping emotions in check, controlling anger, and avoiding aggressive behavior, even in very difficult situations.
Persistence
Job requires persistence in the face of obstacles.

Work Value

Support
Occupations that satisfy this work value offer supportive management that stands behind employees. Corresponding needs are Company Policies, Supervision: Human Relations and Supervision: Technical.
Independence
Occupations that satisfy this work value allow employs to work on their own and make decisions. Corresponding needs are Creativity, Responsibility and Autonomy.
Working Conditions
Occupations that satisfy this work value offer job security and good working conditions. Corresponding needs are Activity, Compensation, Independence, Security, Variety and Working Conditions.
Relationships
Occupations that satisfy this work value allow employees to provide service to others and work with co-workers in a friendly non-competitive environment. Corresponding needs are Co-workers, Moral Values and Social Service.
Achievement
Occupations that satisfy this work value are results oriented and allow employees to use their strongest abilities, giving them a feeling of accomplishment. Corresponding needs are Ability Utilization and Achievement.
Recognition
Occupations that satisfy this work value offer advancement, potential for leadership, and are often considered prestigious. Corresponding needs are Advancement, Authority, Recognition and Social Status.

Related Occupations

Common Lay Titles