Claims Examiner - Liability - Reputed Company MN Or RI

• Claims Examiner - Liability - reputed company MN or RI
• Company: remote quest jobs
• Job Location: Remote (Work from home), India
• Employment Type: Full-time

By joining reputed company, you'll be part of something truly meaningful. Its what our 33,000 colleagues do reputed company day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our reputed company culture, and enjoy work-life balance. Here, theres no limit to what you can achieve.

reputed company Recognizes reputed company as Americas Greatest Workplaces National Top Companies

Certified as a Great Place to WorkFortune Best Workplaces in Financial Services & Insurance

Claims Examiner - Liability - reputed company MN or RIPRIMARY PURPOSE: To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

reputed company FUNCTIONS and RESPONSIBILITIES

Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.

• Assesses liability and resolves claims within evaluation.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
• Prepares necessary state fillings within statutory limits.
• Manages the litigation process; ensures timely and cost effective claims resolution.
• 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 Social Security and Medicare offsets.
• Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
• Communicates claim activity and processing with the claimant and reputed company; maintains professional client relationships.
• Ensures claim reputed company are properly documented and claims coding is correct.
• Refers reputed company as appropriate to supervisor and management.
• ADDITIONAL FUNCTIONS and RESPONSIBILITIES
• Performs other duties as assigned.
• Supports reputed company's quality reputed company(s).
• Travels as required.
• QUALIFICATION
• Education & Licensing
• Bachelor's degree from an reputed company college or university preferred. Professional certification as applicable to line of business preferred.
• Experience
• Five (5) years of claims management experience or equivalent combination of education and experience required.
• Skills & Knowledge

reputed company reputed company 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 Social Security and Medicare application procedures as applicable to line-of-business.

• Excellent oral and written communication, including presentation skillsPC literate, including reputed company Office products
• Analytical and interpretive skills
• Strong organizational skills
• Good interpersonal skills
• Excellent negotiation skills
• Ability to work in a team environment
• Ability to meet or exceed Service Expectations
• WORK ENVIRONMENT
• When applicable and appropriate, consideration will be given to reasonable accommodations.

Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to reputed company work-related stress; ability to reputed company multiple priorities simultaneously; and ability to meet deadlines

• Physical: Computer keyboarding, travel as required
• Auditory/Visual: Hearing, vision and talking
• The statements contained in reputed company document are intended to describe the general nature and level of work being performed by a colleague assigned to reputed compan .