Claims Resolution Specialist
2 weeks ago
Crawford & Company is seeking a skilled Claims Specialist to administer and resolve non-complex short-term claims of low monetary amounts, including medical-only claims. The ideal candidate will have a strong understanding of claim processing and policies, as well as excellent communication and diplomatic skills.
Key Responsibilities- Investigate claims to confirm coverage and determine liability, compensability, and damages.
- Verify policy coverage for submitted claims and notify the insured of any issues.
- Identify wage loss expenses and wage exposures on medical claims.
- Document receipt and contents of medical reports and interact with claimants to understand the nature and extent of injuries and medical conditions.
- Approve payments of medical bills on lost-time disability claims within the area of payment authority.
- Evaluate medical claims for potential fraud issues, loss control, and recovery in accordance with insurance policy contracts, medical bill coding rules, and state regulations.
- Keep the Team Manager informed verbally and in writing of activities and problems within the assigned area of responsibility.
- College degree or the equivalent of education and experience.
- Knowledge of claims and familiarity with claims terminology gained through industry experience and/or specialized courses of study.
- Must have or secure and maintain the appropriate license(s) as required by the state(s) at the adjuster/supervisory/management level.
- Demonstrates a thorough working knowledge of claim processing and claim policies and procedures.
- Demonstrates an understanding of basic medical terminology and appropriate medical tests for claimed conditions.
- Demonstrates effective and diplomatic oral and written communication skills.
Crawford & Company is a leading provider of claims management and outsourcing solutions. Our total compensation plans provide each of our employees with far more than just a great salary. We offer pay and incentive plans that recognize performance excellence, benefit programs that empower financial, physical, and mental wellness, training programs that promote continuous learning and career progression, and a culture of respect, collaboration, entrepreneurial spirit, and inclusion.
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Claims Resolution Specialist
4 days ago
Livonia, Michigan, United States Crawford & Company Full timeJob SummaryCrawford & Company is seeking a skilled Claims Specialist to join our team. As a Claims Specialist, you will be responsible for administering and resolving non-complex short-term claims of low monetary amounts, including medical-only claims.Key ResponsibilitiesConduct thorough investigations of claims to confirm coverage and determine liability,...
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Claims Resolution Specialist
2 weeks ago
Livonia, Michigan, United States Crawford & Company Full timeJob SummaryCrawford & Company is seeking a skilled Claims Specialist to administer and resolve non-complex short-term claims of low monetary amounts, including medical-only claims. The ideal candidate will have a strong understanding of claim processing and policies, as well as excellent communication and diplomatic skills.Key ResponsibilitiesInvestigate...
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