Claims Examiner

3 weeks ago


Atlanta, United States Mindlance Full time

Job Title: Claims Examiner - Workers Compensation Location: Remote Job Length: 3 Months (Possibility of extension) Manager’s Note: · Alaska work comp license or a Property & Casualty adjuster’s license. Job Overview: Analyze complex or technically difficult workers' compensation claims to determine benefits due. Work with high-exposure claims involving litigation and rehabilitation. Ensure ongoing adjudication of claims within service expectations, industry best practices , and specific client service requirements. Identify subrogation of claims and negotiate settlements. ESSENTIAL FUNCTIONS and RESPONSIBILITIES: · Analyzes and processes complex or technically difficult workers' compensation 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. · 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 the client; maintains professional client relationships. · Ensures claim files are properly documented and claims coding is correct. · Refers cases as appropriate to supervisor and management. · Performs other duties as assigned. · Supports the organization's quality program(s). Skills & Knowledge · Subject matter 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 skills · PC literate, including Microsoft 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 Education: · Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.



  • Atlanta, United States Reserv Full time

    Job DescriptionJob DescriptionDescriptionAbout ReservReserv is an insurtech creating and incubating cutting-edge AI and automation technology to bring efficiency and simplicity to claims. Founded by insurtech veterans with deep experience in SaaS and digital claims, Reserv is venture-backed by Bain Capital and Altai Ventures and began operations in May 2022....

  • Claims Examiner

    11 hours ago


    Atlanta, United States Sedgwick Full time

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It's an opportunity to do something meaningful, each and every day. It's having support for your...

  • Claims Examiner

    1 month ago


    Atlanta, United States Mindlance Full time

    Job Title: Claims Examiner - Workers Compensation Location: Remote Job Length: 3 Months (Possibility of extension) Manager’s Note: · Alaska work comp license or a Property & Casualty adjuster’s license. Job Overview: Analyze complex or technically difficult workers' compensation claims to determine benefits due....


  • Atlanta, United States Tristar Insurance Services LLC Full time

    Job DetailsLevel Entry Job Location Atlanta Office - Atlanta, GA Remote Type Fully Remote Position Type Full Time Education Level High School Diploma or GED Salary Range $23.08 - $29.81 Hourly Travel Percentage Negligible Job Shift Day Job Category Insurance Commercial Auto and General Liability Claims Examiner I POSITION SUMMARY: Responsible for promptly...

  • Claims Examiner

    4 days ago


    Atlanta, United States ICONMA Full time

    · To analyze complex or technically difficult workers compensation 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...

  • Claims Examiner

    1 week ago


    Atlanta, United States ICONMA Full time

    · To analyze complex or technically difficult workers' compensation 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...


  • Atlanta, United States Questor Consultants, Inc. Full time

    Job DescriptionJob DescriptionNational Insurance carrier is looking for an experienced medical/health malpractice claims professional that may be located in any of their regional offices i.e. Phoenix, AZ, Atlanta, GA, Chicago, IL, New York City, NY or White Plains, NY. This position would be a hybrid remote type, 2 days in and 3 day at home. Candidate will...

  • Subrogation Examiner

    4 weeks ago


    Atlanta, United States Tristar Insurance Services LLC Full time

    Job DetailsLevel Entry Job Location Atlanta Office - Atlanta, GA Remote Type Fully Remote Position Type Full Time Education Level High School Diploma or GED Salary Range $17.00 - $17.25 Hourly Travel Percentage None Job Shift Day Job Category Admin - Clerical Subrogation ExaminerPLEASE BE SURE TO SIGN THE APPLLICATION AT THE END....THIS IS A REMOTE...


  • Atlanta, United States MRINetwork Jobs Full time

    Job DescriptionJob DescriptionPolikov Recruitment Solutions specializes in recruiting in the Commercial Property & Casualty Insurance industry.We are working on a Chief Claim Specialist role with an A+ rated Carrier that has been in business for over 30 years.The Chief Claim Specialist effectively manages a caseload of Excess/Umbrella/Complex/Major Case...


  • Atlanta, United States Tristar Insurance Services LLC Full time

    Job DetailsLevel Entry Job Location Atlanta Office - Atlanta, GA Remote Type Fully Remote Position Type Full Time Education Level High School Diploma or GED Salary Range $17.00 - $17.25 Hourly Travel Percentage None Job Shift Day Job Category Admin - Clerical Workers Compensation Subrogation ExaminerPLEASE BE SURE TO SIGN THE APPLLICATION AT THE END....THIS...


  • Atlanta, United States Metas Solutions Full time

    Job DescriptionJob DescriptionAbout Us:Metas Solutions is a professional services firm headquartered in Atlanta, GA. We are an 8(a)-certified, Woman Owned Small Business (WOSB/EDWOSB) headquartered in Atlanta GA with offices at StudioPlex in Atlanta's Old Fourth Ward neighborhood. Metas is a professional services firm that offers technical assistance and...


  • Atlanta, United States Metas Solutions Full time

    About Us:Metas Solutions is a professional services firm headquartered in Atlanta, GA. We are an 8(a)-certified, Woman Owned Small Business (WOSB/EDWOSB) headquartered in Atlanta GA with offices at StudioPlex in Atlanta's Old Fourth Ward neighborhood. Metas is a professional services firm that offers technical assistance and consultation to the federal...

  • Settlement Attorney

    1 week ago


    Atlanta, United States State of Georgia Full time

    Jump start your career with impactful work and real-world experience! The State Board of Workers' Compensation is a state agency that serves over a quarter million employers and over 3.8 million workers. The Settlement Division processes an average of 16,000 settlements each year! A Settlement Staff Attorney must be a self-starter, with a positive outlook,...

  • Investigative Auditor

    2 weeks ago


    Atlanta, United States GeorgiaGov Full time

    Office of the Attorney General Department of Law Medicaid Fraud - Investigative Auditor *To move forward in the recruiting process ALL applicants are required to: · Attach a current Resume · Cover Letter · Attach copies of official undergraduate transcripts (unofficial accepted during application process) The mission of the Department of...

  • Public Health Analyst

    1 month ago


    Atlanta, United States Metas Solutions Full time

    Job DescriptionJob DescriptionAbout Us:Metas Solutions is a professional services firm headquartered in Atlanta, GA. We are an 8(a)-certified, Woman Owned Small Business (WOSB/EDWOSB) headquartered in Atlanta GA with offices at StudioPlex in Atlanta's Old Fourth Ward neighborhood. Metas is a professional services firm that offers technical assistance and...


  • Atlanta, United States Pennrose Management Full time

    Overview The Maintenance Supervisor ("MS") will have broad and in-depth responsibilities for the maintenance and repair of an apartment development(s) which may consist of multiple buildings or a single structure. Depending of the size of the assigned development(s) the MS may work alone or lead a Maintenance Technician(s) and possibly a Porter. Reporting...


  • Atlanta, United States Pennrose Management Full time

    Overview The Maintenance Supervisor ("MS") will have broad and in-depth responsibilities for the maintenance and repair of an apartment development(s) which may consist of multiple buildings or a single structure. Depending of the size of the assigned development(s) the MS may work alone or lead a Maintenance Technician(s) and possibly a Porter. Reporting...

  • Service Technician

    4 weeks ago


    Atlanta, United States Peak Performance Team Full time

    Job DescriptionJob DescriptionService Technician – Automotive Dealerships in Atlanta, GA areaSigning bonus opportunity for experienced techs - apply for consideration!Our dealerships run honest shops and need honest, hard-working techs. To be a success at our dealerships, you need to have solid skills and solid ethics. We also know that to keep a good...


  • Atlanta, United States Stealth Full time

    Introduction:Our firm is a distinguished California law firm specializing in workers' compensation, employment, liability, audit defense, and subrogation law. We are committed to providing exceptional legal representation and offer a dynamic work environment with rewarding opportunities for professional growth.Key Responsibilities:Legal Advocacy:● Advocate...


  • Atlanta, Georgia, United States Pennrose Management Full time

    Overview: The Maintenance Technician (“MT”) will have responsibilities for the maintenance and repair of an apartment development(s) which may consist of multiple buildings or a single structure.    Reporting to their assigned Maintenance Supervisor the MT will ensure their assigned apartment development(s) is maintained to company and...