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Claims Assessment Specialist

2 months ago

California City, California, United States Infojini Full time
Position Overview:
As a Claims Assessment Specialist at Infojini, you will play a crucial role in the claims management process. This position involves receiving claim assignments, verifying policy coverages, and facilitating the acknowledgment of claims.

- You will utilize independent judgment to interpret and make decisions on moderately complex claims and applicable policy coverages.


Key Responsibilities:
  • Conduct thorough investigations, evaluations, negotiations, and adjudications of both first and third-party claims to ascertain their validity and assess the extent of damages through communication with clients, claimants, witnesses, and other relevant parties.
  • Analyze claims activity and generate comprehensive reports for clients, carriers, and management.
  • Establish reserves using your expertise and independent judgment, authorizing payments within your scope of authority to settle claims efficiently while ensuring timely disbursements.
  • Make prompt and fair settlement decisions, issuing company drafts for claims within your authority limits.
  • Identify subrogation and third-party recovery opportunities, adhering to reclaim procedures.
  • Participate in claim reviews and contribute to the analysis of claims activities, preparing reports for clients, carriers, and management.

Required Skills:
To excel in this role, you should possess the following abilities:
  • Strong verbal and written communication skills.
  • Proven capability to gather and analyze information, determine appropriate actions, and implement chosen strategies.
  • Exceptional problem identification, analysis, and resolution skills.
  • Effective interpersonal skills to engage with external sources and all levels of employees.

Education and Experience:
A Bachelor's degree or equivalent experience is required, along with:
  • A minimum of 13 years of comprehensive claims investigation and settlement experience within a claims or similar organization.