청구 조정원, 심사관 및 조사관
경영·재무 운영직Claims Adjusters, Examiners, and Investigators
- O*NET-SOC 코드
- 13-1031.00
Review settled claims to determine that payments and settlements are made in accordance with company practices and procedures. Confer with legal counsel on claims requiring litigation. May also settle insurance claims.
한국어 직업명은 AI Changing Work의 번역입니다. 과업 문장과 원천 값은 공표된 영문 그대로 표시합니다.
AI 노출도
- 데이터 출처: BLS발행 시점: 2026-08
매우 높음· 상대
낮음4단계 상대 범주매우 높음직업군 단위 값
척도 · 모수 · 출처
4단계 상대 범주 (낮음 / 보통 / 높음 / 매우 높음)
BLS 고용전망 표의 세부직업 831개 기준. 값은 NEM(전국고용매트릭스) 코드 단위로 부여되므로, 같은 NEM 코드를 쓰는 직업은 같은 밴드를 받습니다
- 데이터 출처: Anthropic발행 시점: 2026-03
0.082
0.000여기 실린 값의 범위0.745척도 · 모수 · 출처
관측 노출 지수, 발행된 그대로 0–1
O*NET 과업 매핑 기준
SOC 2018 직업 단위로 발행된 값이며, 같은 SOC 2018 코드를 가진 O*NET 직업은 모두 이 값을 받습니다
- 데이터 출처: ILO발행 시점: 2025
0.45
0.09여기 실린 값의 범위0.70직업군 단위 값
척도 · 모수 · 출처
생성형 AI 노출 지수, 발행된 그대로 0–1
ISCO-08 직업군 단위로 발행된 값입니다. 미국 노동통계국(BLS)의 공식 교차표(ISCO-08→2010 SOC, 2010 SOC→2018 SOC)를 그대로 적용해 이 직업에 연결했으며, 연결은 전부 또는 일부 대응입니다
이 원천이 어떤 종류의 값인가
BLS 범주는 절대 수준이 아니라 상대 순위이며, 1차 측정도 아닙니다. 여러 선행 연구가 매긴 직업별 백분위 순위를 4단계로 묶은 값입니다. 고용·임금 예측도, 도입 확률도 아니며 자동화와 증강을 구분하지 않습니다.
AI 노출도 (OpenAI 루브릭)
평가 과업 29개 · β ≥ 0.5 인 과업 28개 (96.6%)
β = 직접 노출(E1) + 0.5 × 도구 활용 시 노출(E2). 원본 저장소의 정의를 따릅니다.
- 원천 단위: O*NET 27.2 과업 → O*NET 31.0 직업 코드
- 채점된 과업이 모두 O*NET 31.0 과업 목록에 있습니다.
- 출처
- OpenAI "GPTs are GPTs" exposure rubric
- 판
- gh-main-0471612
- 라이선스
- MIT License, Copyright (c) 2024 OpenAI
과업
O*NET® 31.0 Database의 과업 문장입니다. 핵심(Core) 과업을 먼저 보입니다.
| 과업 | 유형 | β (OpenAI) |
|---|---|---|
| Examine claims forms and other records to determine insurance coverage. | 핵심 | 0.5 |
| Analyze information gathered by investigation and report findings and recommendations. | 핵심 | 0.5 |
| Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability. | 핵심 | 0.5 |
| Investigate and assess damage to property and create or review property damage estimates. | 핵심 | 0.5 |
| Interview or correspond with agents and claimants to correct errors or omissions and to investigate questionable claims. | 핵심 | 0.5 |
| Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review. | 핵심 | 0.5 |
| 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. | 핵심 | 0.5 |
| Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies. | 핵심 | 0.5 |
| Resolve complex, severe exposure claims, using high service oriented file handling. | 핵심 | 0.5 |
| Pay and process claims within designated authority level. | 핵심 | 0.5 |
| Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments. | 핵심 | 0.5 |
| 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. | 핵심 | 0.5 |
| Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation. | 핵심 | 1 |
| Refer questionable claims to investigator or claims adjuster for investigation or settlement. | 핵심 | 0.5 |
| Collect evidence to support contested claims in court. | 핵심 | 0.5 |
| Confer with legal counsel on claims requiring litigation. | 핵심 | 0.5 |
| Contact or interview claimants, doctors, medical specialists, or employers to get additional information. | 핵심 | 0.5 |
| Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis. | 핵심 | 0.5 |
| Present cases and participate in their discussion at claim committee meetings. | 핵심 | 0.5 |
| Report overpayments, underpayments, and other irregularities. | 핵심 | 0.5 |
| Attend mediations or trials. | 핵심 | 0 |
| Supervise claims adjusters to ensure that adjusters have followed proper methods. | 보조 | 0.5 |
| Conduct detailed bill reviews to implement sound litigation management and expense control. | 보조 | 0.5 |
| Examine titles to property to determine validity and act as company agent in transactions with property owners. | 보조 | 0.5 |
| Communicate with reinsurance brokers to obtain information necessary for processing claims. | 보조 | 1 |
| Prepare reports to be submitted to company's data processing department. | 보조 | 1 |
| Obtain credit information from banks and other credit services. | 보조 | 0.5 |
| Communicate with former associates to verify employment record or to obtain background information regarding persons or businesses applying for credit. | — | 0.5 |
| Negotiate claim settlements or recommend litigation when settlement cannot be negotiated. | — | 0.5 |
직업 정보
출처와 귀속
This page includes information from the O*NET® 31.0 Database (https://www.onetcenter.org/database.html) by the U.S. Department of Labor, Employment and Training Administration (USDOL/ETA). Used under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/). O*NET® is a trademark of USDOL/ETA. AI Changing Work has modified all or some of this information: the O*NET-SOC code, title and task statements are reproduced in English without change; task-type labels are shown in the page's language and tasks are listed core first; any Korean occupation title shown on the Korean-language page is AI Changing Work's translation; any KSCO-8 unit groups linked to this occupation were paired with it by AI Changing Work's judgment, and the relation labels and statuses are AI Changing Work's additions. USDOL/ETA has not approved, endorsed, or tested these modifications.
Any AI exposure figures on this page are published by third parties, not by AI Changing Work, and none is part of the O*NET information. OpenAI publishes task-level scores (MIT License) for O*NET 27.2 task statements; each is shown next to the O*NET 31.0 task statement with the same task ID, whose wording can differ from the 27.2 statement that was scored. OpenAI also publishes occupation-level scores for O*NET-SOC codes in the same release, and any such score is shown on the O*NET occupation with the same code. Anthropic publishes an observed exposure index in the Anthropic Economic Index (CC-BY), and the U.S. Bureau of Labor Statistics publishes relative AI exposure categories (public domain); both are published per SOC code, and each value is shown on every O*NET occupation with that code. The International Labour Organization publishes a generative AI exposure index in ILO Working Paper 140 (CC BY 4.0) for ISCO-08 unit groups; AI Changing Work links those groups to O*NET occupations by applying the U.S. Bureau of Labor Statistics ISCO-08 to 2010 SOC and 2010 SOC to 2018 SOC crosswalks as published, without case-by-case selection, and these crosswalks match many groups only in part. Where several unit groups are linked, each group's published value is listed, and any summary shows only the lowest and highest of those values with the number of groups; no exposure figure is averaged or recalculated. Any employment figures are published by the U.S. Bureau of Labor Statistics for the SOC group containing this occupation. Each source is credited where its figures are shown.
O*NET OnLine: 13-1031.00 Claims Adjusters, Examiners, and Investigators
KSCO 코드·명칭: 한국표준직업분류(제8차 개정) — 통계청 고시 제2024-328호 (2024-07-01 고시, 2025-01-01 시행). 저작권법 제7조 제2호의 고시 항목이다. 명칭 표기(가운뎃점·띄어쓰기)는 해설서 2차 정오 반영판의 표기를 따랐으며, 고시 항목표와는 18개 명칭에서 가운뎃점 글리프나 띄어쓰기만 다르다. 통계청은 2025년 10월 국가데이터처로 개편되었다. 이 페이지의 KSCO 연결은 통계청·국가데이터처의 공식 연계표가 아니다.