Claim Examiner

4 weeks ago

Dallas, United States Select Source International Full time

Job Description Job Description

Job Description

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:

Licensing requirements vary by state.

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.

Desired Qualities:

General knowledge of state and national laws and regulations.

General understanding of medical and legal terms.

Must Have - NY Adjuster License

Company Description

Select Source International (SSI) is an IT, Health Care, and Engineering Services consulting firm that has been in business since 1998. SSI consultants have provided exceptional services that have been appreciated by clients, customers, and users alike at several large Fortune 500 companies, mid-size enterprises, and consulting companies.

Company Description Select Source International (SSI) is an IT, Health Care, and Engineering Services consulting firm that has been in business since 1998. SSI consultants have provided exceptional services that have been appreciated by clients, customers, and users alike at several large Fortune 500 companies, mid-size enterprises, and consulting companies.

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