Job Category : Claims Job Code : Claim Examiner- WC : BS Job Title : Claim Examiner- WC Keywords : Number of Positions : Remaining Positions : Duties : 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. Skills : 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.
Education : Bachelor's degree or equivalent experience required. - Comprehensive claims investigations / settling experience - years experience in Claims or similar organization Languages : English Read Write Speak Attachments : Skills and Experience Skills : Required
- CLIENT COMMUNICATION
- GREAT ORGANIZATIONAL SKILLS
- CUSTOMER SERVICE
- PAYMENTS
- CLAIMS
Additional Languages : English( Speak, Read, Write ) Minimum Degree Required : Also Preferred : Location Client Location Country : United States State / Province : Illinois City : Lake Zurich Address : Corporate Drive, Suite , IL POSTAL CODE : Work Location Same as Client Location Other Client Location Work Completed Offsite Country : United States State / Province : Illinois City : TBD Street Address : Street Address : POSTAL CODE : TBD Schedule Start Date : / / Hours Per Week : Est.
End Date : / / Hours Per Day : Schedule Notes : Days Per Week :