Claims Examiner
2 weeks ago
Rose International seeks a skilled Claims Examiner to analyze complex workers' compensation claims and ensure timely resolution. The ideal candidate will possess strong analytical and negotiation skills, with a minimum of 5 years of experience in claims management.
Key Responsibilities- Analyze and process complex claims, investigating and gathering information to determine exposure and develop action plans for resolution.
- Negotiate settlements within designated authority levels and calculate reserves to ensure timely and appropriate payments.
- Manage litigation processes, ensuring cost-effective claims resolution and coordinating vendor referrals as needed.
- Utilize cost containment techniques, including strategic vendor partnerships, to reduce overall claim costs.
- Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets.
- Communicate claim activity and processing with claimants and clients, maintaining professional relationships.
- Ensure accurate documentation and coding of claims files.
- Bachelor's degree from an accredited college or university (preferred).
- Professional certification applicable to the line of business (preferred).
- Five (5) years of claims management experience or equivalent combination of education and experience.
- Subject matter expertise in insurance principles, laws, and regulations.
- Excellent oral and written communication, including presentation skills.
- PC literate, including Microsoft Office products.
- Analytical and interpretive skills.
- Strong organizational and interpersonal skills.
- Ability to work in a team environment and meet or exceed service expectations.
Rose International offers a competitive benefits package, including [insert benefits details]. For more information, please visit [insert link].
Rose International is an Equal Opportunity Employer, committed to diversity and inclusion. We welcome applications from qualified candidates and are an affirmative action employer.
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Atlanta, Georgia, United States Rose International Full timeJob Title: Claims ExaminerWe are seeking a skilled Claims Examiner to join our team at Rose International. As a Claims Examiner, you will be responsible for analyzing complex workers' compensation claims to determine benefits due.Key Responsibilities:Analyze complex or technically difficult workers' compensation claims to determine benefits dueWork with high...
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Atlanta, Georgia, United States Rose International Full timeJob SummaryWe are seeking a highly skilled Claims Examiner to join our team at Rose International. As a Claims Examiner, you will be responsible for analyzing complex workers' compensation claims, investigating and gathering information to determine the exposure on the claim, and managing claims through well-developed action plans to an appropriate and...
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