Senior Claims Examiner

3 weeks ago


Downers Grove, Illinois, United States Vitus Search Group Full time

Job Title: Senior Claims Examiner

Job Summary:

We are seeking a highly motivated and detail-oriented Senior Claims Examiner to join our team in a full-time, permanent, Hybrid position with comprehensive benefits. The ideal candidate will possess exceptional claims handling experience and a proven track record of building rapport with clients to facilitate amicable resolutions of liability claims.

Key Responsibilities:

  • Claims Analysis: Thoroughly review and analyze claims to ascertain their validity and extent of coverage in accordance with policy provisions.
  • Investigation: Conduct comprehensive investigations by gathering pertinent information, including statements from claimants, witnesses, and medical professionals.
  • Settlement Negotiations: Engage in negotiations with claimants and other parties involved in the claims process to achieve mutually beneficial settlements.
  • Financial Record Keeping: Utilize specialized financial software to meticulously document findings and maintain an accurate record of all claims-related activities.
  • Compliance: Adhere to workers' compensation laws and regulations throughout the claims process, ensuring adherence to industry standards.
  • Fraud Detection: Implement robust fraud detection measures to identify potentially fraudulent claims and take appropriate actions.
  • Customer Service: Provide exceptional customer service by promptly addressing inquiries and concerns from claimants.
  • Reporting: Prepare comprehensive reports summarizing findings and recommendations for each claim, ensuring clarity and conciseness.

Preferred Qualifications:

  • Proven experience in handling workers' compensation claims.
  • Strong organizational abilities to manage multiple claims simultaneously and meet tight deadlines.
  • Proficiency in data analysis and decision-making based on analytical insights.
  • Excellent negotiation skills to facilitate effective settlements.
  • Familiarity with financial software utilized within the insurance industry is advantageous.
  • A background in customer service is essential to ensure positive interactions with claimants.
  • Knowledge of auto estimating processes is beneficial but not mandatory.

Qualifications:

  • Strong negotiation skills to effectively handle settlement discussions
  • Proficiency in utilizing financial software for claims processing and analysis
  • Experience in auto estimating to accurately assess repair costs
  • Knowledge of workers' compensation law to navigate the legal aspects of claims
  • Excellent organizational skills to manage multiple claims efficiently
  • Ability to provide exceptional customer service throughout the claims process


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