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Insurance Claims Specialist

2 months ago

Myrtle Point, Oregon, United States Collabera Full time
Job Title: Claims Examiner
Location: REMOTE
Duration: 7+ months
Pay range: 18-20/hr.

Job Overview
This position involves the examination of claims related to travel insurance. A valid New York state adjuster's license is mandatory, with additional state licenses being advantageous.

Key Responsibilities:
  • Conduct thorough investigations, evaluations, and resolutions of claims, utilizing both technical expertise and interpersonal skills to ensure fair and timely case management.
  • Adjust reserves or provide recommendations to align reserve activities with corporate standards.
  • Handle complex claims with a focus on high-quality service and effective file management.
  • Process claims and issue payments within the established authority limits.
  • Review claims assessed by insurance adjusters, conducting further inquiries on questionable claims to determine payment authorization.
  • Verify and analyze data pertinent to claims settlements to confirm validity and adherence to company protocols.
  • Input claim payments, reserves, and new claims into the computer system, ensuring clear and adequate documentation.
  • Collaborate with legal counsel on claims that necessitate litigation.
  • Engage with claimants, medical professionals, or employers to gather additional information as needed.
  • Maintain organized claim files, including records of settled claims and an inventory of claims requiring detailed scrutiny.
Qualifications:
  • Bachelor's Degree.
  • Active New York state adjuster's license required; multiple state licenses are a plus.
  • Proficient in analytical tools, document management, and database query software.
  • Strong skills in MS Office applications.
  • Two to four years of relevant work experience.
  • Exceptional attention to detail.
  • Outstanding customer service and communication abilities.
  • General understanding of state and national regulations.
  • Familiarity with medical and legal terminology.
  • Experience in a claims production environment with established goals and quality metrics.