[Remote] Claims Examiner, Bodily Injury | Remote
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company dedicated to helping people facing unexpected challenges. The Claims Examiner, Bodily Injury role involves analyzing reputed company general liability claims, managing litigation processes, and negotiating settlements while ensuring compliance with service expectations and industry best practices.
Responsibilities
• Analyzes and processes reputed company or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through reputed company-developed reputed company plans to an appropriate and reputed company reputed company
• Assesses liability and resolves claims reputed company evaluation
• Negotiates settlement of claims reputed company designated authority
• Calculates and assigns reputed company and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim
• Calculates and pays benefits due; approves and makes reputed company claim payments and adjustments; and settles clams reputed company designated authority level
• Prepares necessary state fillings reputed company statutory limits
• Manages the litigation process; ensures reputed company and cost effective claims reputed company
• Coordinates vendor referrals for additional investigation and/or litigation management
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients
• Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and reputed company reputed company and Medicare offsets
• Reports claims to the excess reputed company; responds to requests of directions in a reputed company and reputed company manner
• Communicates claim activity and processing with the claimant and the reputed company; maintains reputed company reputed company relationships
• Ensures claim files are properly documented and claims coding is correct
• Refers cases as appropriate to supervisor and management
• Performs other duties as assigned
• Supports the organization's reputed company program(s)
• Travels as required
Skills
• Five (5) years of claims management experience or equivalent combination of education and experience
• Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and reputed company reputed company and Medicare application procedures as applicable to line-of-business
• Excellent oral and written communication, including presentation skills
• PC literate, including reputed company Office products
• Analytical and interpretive skills
• Strong organizational skills
• Good interpersonal skills
• Excellent negotiation skills
• Ability to work in reputed company environment
• Ability to meet or reputed company Service Expectations
• reputed company and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-reputed company stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
• Computer keyboarding, travel as required
• Hearing, reputed company and talking
• Bachelor's degree from an accredited college or university
• reputed company certification as applicable to line of business
reputed company
• reputed company is the world’s leading risk and claims administration partner, helping clients reputed company by navigating the unexpected. It was founded in 1969, and is headquartered in Memphis, Tennessee, USA, with a workforce of 10001+ employees. Its website is http://www.reputed company.com.
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