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Claim Examiner

2 months ago

Garden City, United States BCforward Full time

Claim Examiner - US

BCForward is currently looking for Claim Examiner in Garden City, NY 11530

Job Title: Claim Examiner

Work Location: Garden City, NY 11530

Expected Duration: 6+ Months

Estimated Start Date: 08/26/2024

Pay Rate: $20/hr on W2

Responsibilities:

* Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.

* Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.

* Resolve complex, severe exposure claims, using high service-oriented file handling.

* Pay and process claims within designated authority level.

* Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
* Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.

* Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.

* Confer with legal counsel on claims requiring litigation.

* Contact or interview claimants, doctors, medical specialists, or employers to get additional information.

* Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis.

Qualifications/Education:

* Bachelor's Degree.

* Licensing requirements vary by state: Active New York state adjuster's license required; multiple state licenses encouraged.

* Proficiency in analytical, document management, and database query software.

* Proficiency in Microsoft Office applications.

* Two to four years of work-related experience.

* Exceptional attention to detail.

* Excellent customer service and communication skills.

* General knowledge of state and national laws and regulations.

* General understanding of medical and legal terms.

* Experience in a claims production environment with set goals and quality scores that must be obtained.

Benefits:

BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

About BCforward:

Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.

Interested candidates please send resume in Word format Please reference job code 226688 when responding to this ad.