Claims Examiner
4 weeks ago
· 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 negotiate settlements.
· 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).
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Claims Examiner
2 weeks ago
Atlanta, United States US Tech Solutions Full timeJob Title: Claims Examiner Location: Remote Duration: 06 months contract (C2H) Job Description: 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...
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Claims Examiner
6 days ago
Atlanta, United States US Tech Solutions Full timeJob Title: Claims Examiner Location: Remote Duration: 06 months contract (C2H) Job Description: 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...
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Claims Examiner
2 weeks ago
Atlanta, United States US Tech Solutions, Inc. Full timeJob Title: Claims Examiner Location: Remote Duration: 06 months contract (C2H) Job Description: 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...
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Claims Examiner
3 days ago
Atlanta, United States US Tech Solutions Full timeJob Title: Claims Examiner Location: Remote Duration: 06 months contract (C2H) Job Description: 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...
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Claims Examiner
2 weeks ago
Atlanta, United States US Tech Solutions, Inc. Full timeJob Title: Claims Examiner Location: Remote Duration: 06 months contract (C2H) Job Description: 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...
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Claims Examiner
17 hours ago
Atlanta, United States US Tech Solutions, Inc. Full timeJob Title: Claims Examiner Location: Remote Duration: 06 months contract (C2H) Job Description: 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...
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Medicare Claims Examiner
2 weeks ago
Atlanta, United States Bankers Fidelity Life Insurance Cor Full time**Summary**: The claims examiner is responsible for processing the Medicare Supplement claims adjudication. The role is responsible for the accurate input of claims information as well as reviewing and analyzing claims to determine eligibility. In addition, the claim examiner may be involved in claims projects including research, resolution of discrepancies...
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Associate Claims Examiner
1 week ago
Atlanta, United States Berkshire Hathaway Specialty Insurance Full timeWho are we? A strategic and trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI), provides a broad range of commercial property, casualty and specialty insurance coverages and outstanding service to customers and brokers around the world. Part of Berkshire Hathaway's insurance operations, we bring our solutions to market with our stellar...
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Associate Claims Examiner
19 hours ago
Atlanta, United States Berkshire Hathaway Specialty Insurance Full timeWho are we? A strategic and trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI), provides a broad range of commercial property, casualty and specialty insurance coverages and outstanding service to customers and brokers around the world. Part of Berkshire Hathaway's insurance operations, we bring our solutions to market with our stellar...
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Associate Claims Examiner
1 week ago
Atlanta, United States Berkshire Hathaway Specialty Insurance Full timeJob DescriptionJob DescriptionWho are we? A strategic and trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI), provides a broad range of commercial property, casualty and specialty insurance coverages and outstanding service to customers and brokers around the world. Part of Berkshire Hathaway’s insurance operations, we bring our...
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Associate Claims Examiner
9 hours ago
Atlanta, United States Berkshire Hathaway Specialty Insurance Full timeJob DescriptionJob DescriptionWho are we? A strategic and trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI), provides a broad range of commercial property, casualty and specialty insurance coverages and outstanding service to customers and brokers around the world. Part of Berkshire Hathaway’s insurance operations, we bring our...
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Litigation Claims Examiner
1 month ago
Atlanta, United States Reserv Full timeJob 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....
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Senior Workers Compensation Claims Examiner
4 weeks ago
Atlanta, United States AIG - American International Group, Inc. Full timeAt AIG, we are reimagining the way we help customers to manage risk. Join us as a Senior Workers Compensation Claims Examiner to play your part in that transformation. Its an opportunity to grow your skills and experience as a valued member of the t Workers Compensation, Claims, Examiner, Worker, Compensation, Senior, Administrative
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Claims Examiner
2 weeks ago
Atlanta, United States Sedgwick Full timeTaking 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...
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Claims Examiner
15 hours ago
Atlanta, United States Sedgwick Full timeTaking 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...
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Atlanta, United States Tristar Insurance Services LLC Full timeJob 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...
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Atlanta, United States Tristar Insurance Services LLC Full timeJob 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...
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Atlanta, United States King's Insurance Staffing Full timeOur client has been experiencing continued growth and seeking to add (2) Senior Auto Liability/Bodily Injury Claims Examiners for their Maryland office. This person would be responsible for handling moderate to complex Auto Liability and Bodily Injury claims for losses throughout the Mid-Atlantic region. Responsibilities of this position include...
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Atlanta, United States King's Insurance Staffing Full timeOur client has been experiencing continued growth and seeking to add (2) Senior Auto Liability/Bodily Injury Claims Examiners for their Maryland office. This person would be responsible for handling moderate to complex Auto Liability and Bodily Injury claims for losses throughout the Mid-Atlantic region. Responsibilities of this position include...
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Sr. Claims Examiner, Healthcare
1 month ago
Atlanta, United States Questor Consultants, Inc. Full timeJob 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...
