Home > Term: claims adjudicator
claims adjudicator
A professional who adjudicates claims for benefits offered under governmental social insurance program, such as those dealing with unemployed, retired, or disabled workers, veterans, dependents, or survivors. Responsibilities include:
- Reviews and evaluates data on documents and forms, such as claim applications, birth or death certificates, physician's statements, employer's records, vocational evaluation reports, and other similar records.
- Interviews or corresponds with claimants or agents to elicit information, correct errors or omissions on claim forms, and to investigate questionable data.
- Authorizes payment of valid claims, or notifies claimant of denied claim and appeal rights.
- Reevaluates evidence and procures additional information in connection with claims under appeal or in cases requiring investigation of claimant's continuing eligibility for benefits.
- Prepares written reports of findings.
- May specialize in one phase of claim program, such as assisting claimant to prepare forms, rating degree of disability, investigating appeals, or answering questions concerning filing requirements and benefits provided.
- May be designated according to type of benefit-claim adjudicated.
- May act as consultant to board rating disability.
- Sõnaliik: noun
- Valdkond/domeen: Professional careers
- Category: Occupational titles
- Company: U.S. DOL
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- Jason F
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(United States of America)