eTeam · 1 day ago

Claims Examiner

United States

Contract

Remote

Entry, Mid Level

$20/hr - $20/hr

2+ years exp

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Information Technology

Growth Opportunities

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Responsibilities

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.

Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.

Resolve complex, severe exposure claims, using high service-oriented file handling.

Pay and process claims within designated authority level.

Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.

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.

Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.

Confer with legal counsel on claims requiring litigation.

Contact or interview claimants, doctors, medical specialists, or employers to get additional information.

Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Multi States Adjusters LicenseAnalytical Software ProficiencyDocument Management Software ProficiencyDatabase Query Software ProficiencyMicrosoft Office ProficiencyCustomer Service SkillsLegal TermsClaims Production Experience