The candidate should be an analytical and creative problem solver with the ability to identify key issues for coverage, liability, and damage evaluation.
Our claim examiners are assertive decision makers with a strong desire to persuade through negotiation and conflict management.
The claims team offers ongoing challenges, even for the most experienced professional, as every claim is unique, providing new opportunities to learn and grow.
Essential Functions :
Our Professional, Casualty and Property claims teams are growing! We are looking for claim examiners of all experiences for our open positions.
We offer amazing benefits (including medical insurance paid 100% by the company). Core responsibilities include confirming coverage and evaluating liability and damages.
The examiner conducts a thorough and focused investigation on covered claims using independent adjusters, as appropriate.
Investigations include securing all pertinent facts, statements & documents. The examiner prepares letters to the policyholder such as disclaimers and reservation of rights.
The examiner is responsible for posting initial reserves and ensuring reserve adequacy throughout the life of a claim as new information develops.
The examiner is responsible for documenting clear, substantive, timely and proactive efforts to resolve each claim. The examiner is accountable for all aspects of claim handling and must have effective follow through via diary, direction to defense counsel & independent adjusters.
The examiner prepares comprehensive and concise authority requests, reinsurance reports, serious loss reports and will communicate with underwriting and other teams to help keep our products healthy.
Other Duties and Responsibilities :
In addition to the essential functions, an examiner is expected to provide excellent customer service by responding the same day to phone and email both internally and externally and adhere to established claim service promises.
The position may entail completion of special projects. There is an expectation for enrollment in continuing education to maintain state licenses and to support both professional and personal development.
Occasional travel required i.e. attendance at mediation.
Specific Skills :
Strong oral and written communication skills, insightful analytical skills, effective negotiation skills, strong organizational and time management skills, technical knowledge of insurance coverage, negligence law and claim evaluation.
Minimum Job Requirements :
At USLI, our goal is to strengthen our community and culture by representing all races, genders, religions and sexual orientations.
We continue to move conversations about diversity, equity and inclusion forward to ensure every community member has a sense of belonging, a voice and a seat at the table.
USLI provides full-time community members with a comprehensive benefits package, access to wellness programs, continuing education resources, and multiple opportunities to get involved with charitable organizations.
Claims Examiner or Associate Claims Examiner
Our Professional, Casualty and Property claims teams are growing! We are looking for claim examiners of all experiences for our open positions. The examiner prepares comprehensive and concise authority requests, reinsurance reports, serious loss reports and will communicate with underwriting and oth...
Claims Examiner - Cyber/Crime
The Claims Examiner adjudicates assigned claims within given authority and provides operational support to the claims team, This person will also:. The claims staff are empowered to manage their claims within given authority to provide fair and fast resolution of claims for our insured and broker pa...
Claims Examiner - Auto
Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims. It means having flexibility and time for all the things that are important to you. It’s having support for your mental, physical, financial and professional needs. A career at Sedgwick is...
Senior Claims Examiner - BI
Subject matter expertise Mediation, arbitration or trial attendance Demonstrated take charge attitude and ability to work with minimal oversight within their authority levels Identifies and suggests improvements to processes within the claim department and raises with manager Demonstrated steps take...
Claims Integrity Supervisor
Associate degree in health information technology, finance, or a similar field, OR. Evaluating team performance through individual audits and providing feedback to the Senior Claims Integrity Manager. Keeping staff informed of new or updated standards, systems, procedures, forms, and manuals through...
Claims Integrity Specialist
As a member of our team, you'll have the opportunity to work with a diverse group of individuals, making every workday fun and exciting. The Claims Integrity Specialist will be responsible for managing the day-to-day accounts receivable (A/R) and handling inquiries from insurance companies. Ability ...
Claims Integrity Supervisor
Associate degree in health information technology, finance, or a similar field, OR. Evaluating team performance through individual audits and providing feedback to the Senior Claims Integrity Manager. Keeping staff informed of new or updated standards, systems, procedures, forms, and manuals through...
Insurance Claims Associate
We are seeking the ideal candidate for our Claims Associate opening for our growing insurance company!. The Claims Associate will be responsible for assisting the Claims Department in overall productivity. Assist adjusters by directing customers through the claims process and answering claims relate...
Claims Integrity Specialist
They work in 50 offices across 12 states and work directly with the local homeowner / clients to build custom homes in affordable to semi-custom niche. They will directly support the Project Manager and General Manager for all critical admin duties to ensure all construction projects are performed/e...
Claims Integrity Supervisor
Associate degree in health information technology, finance, or a similar field, OR. Evaluating team performance through individual audits and providing feedback to the Senior Claims Integrity Manager. Keeping staff informed of new or updated standards, systems, procedures, forms, and manuals through...