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Claim Examiner- WC

extra holidays

Remote:

Full Remote

Contract:

Work from:

Texas (USA), United States

Offer summary

Experience in claims processing, Strong analytical skills, Knowledge of policy coverages, Ability to work independently.

TalentBurst, an Inc 5000 company Human Resources, Staffing & Recruiting Large https://www.talentburst.com/

1001 - 5000 Employees

Title: Claim Examiner- WC
Location: Remote TX
Duration: 3+ months
Details:

Receives claim assignment, confirms policy coverages and directs acknowledgement of claims.
Interprets and makes decisions using independent judgment on moderate difficulty claims and policy coverages and determines if coverages apply to claims submitted. Investigates, evaluates, negotiates and adjudicates first and third party claims to determine validity and verify extent of damage by telephone contact with clients, claimants, witnesses or other parties as required.
Analyzes claims activity and prepares reports for clients/carriers and management.
Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements.
Make settlement decisions promptly and equitably and issues company drafts in payments for claims within authority limits.
Develops subrogation and third party recovery potential and follows reclaim procedures.
Analyzes claims activities and prepares reports for clients, carriers and/or management. Participates in claim reviews.

Looking for:

Ability to work independently while assimilating various technical subjects.
Good verbal or written communication skills.
Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action.
Strong ability to identify, analyze and solve problems.
Effective interpersonal skills to be capable of dealing with external sources and all levels of employees.

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