EPITEC · 14 hours ago
Claim Examiner
Garden City, NY
Contract
Remote
Entry, Mid Level
$16/hr - $18/hr
2+ years exp
Maximize your interview chancesInformation TechnologyStaffing Agency
Hiring Manager
Madison H.
Insider Connection @EPITEC
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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
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Required
Active New York Adjusters License.
Bachelor’s Degree.
Proficiency in analytical, document management, and database query software.
Proficiency in Microsoft Office applications.
Two to four years of work-related experience.
Exceptional attention to detail.
Excellent customer service and communication skills.
General knowledge of state and national laws and regulations.
General understanding of medical and legal terms.
Experience in a claims production environment with set goals and quality scores that must be obtained.
Preferred
Multiple state licenses encouraged.
Company
EPITEC
Epitec is a premier technology services and professional staffing company.
1001-5000 employees
H1B Sponsorship
EPITEC has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (121)
2022 (183)
2021 (244)
2020 (284)
Funding
Current Stage
Late StageLeadership Team
Mark Ruma
Chief Operating Officer (COO)
Company data provided by crunchbase
