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Claims Examiner I
2 months ago
We are seeking a skilled Claims Examiner I to join our team at LotSolutions, Inc. This role involves delivering exceptional customer service to insureds, members, and accounts while enforcing contractual requirements impartially and efficiently.
Key Responsibilities- Adjudicate claims by reviewing information and taking appropriate action to pay, request additional information, or deny benefits based on coverage, provisions, and exclusions.
- Investigate claims of a potentially fraudulent nature and review findings with management.
- Communicate with members, employers, accounts, and vendors to retrieve information to validate claims.
- Analyze information and make payments or adjustments as needed.
- Maintain accurate claims-related statistics and documentation.
- Claims Adjusters All Lines 6-20 License preferred.
- High School Diploma or equivalent.
- 2 years of experience on PC.
- 2 years' experience in claims and/or other related claims processes.
- Experience with AS400 preferred.
- Customer Service training is imperative.
- Fraud Awareness training and Claims Experience required.
Full benefit package including medical, dental, life, vision, company-paid short/long-term disability, 401(k), tuition assistance, and more.
