Medical Claims Examiner

17 hours ago

Colorado Springs, Colorado, United States USAA Full time
Job Summary

We are seeking a highly skilled Medical Claims Adjuster to join our team at USAA. As a Medical Claims Adjuster, you will be responsible for adjusting attorney-involved moderately complex bodily injury and UM claims, as well as catastrophic auto PIP/MP medical claims.

Key Responsibilities
  • Identify and manage existing and emerging risks associated with business activities
  • Ensure risks are effectively identified, measured, monitored, and controlled
  • Adjust attorney-involved moderately complex bodily injury claims with demonstrable injuries and UM claims
  • Adjust catastrophic 1st party PIP/MP medical claims
  • Investigate loss details, determine legal liability, evaluate, negotiate, and arrive at claim settlement within appropriate authority guidelines
  • Clearly document thought process, investigation, evaluation, negotiation, and settlement decisions
  • Prioritize and manage assigned claims workload to keep members and other involved parties informed
  • Partner and/or direct vendors and internal business partners to facilitate timely claims resolution
Requirements
  • Deep knowledge and understanding of the auto claims contract and application of case law and state laws and regulations
  • Acquisition and maintenance of insurance adjuster license within 90 days and designated number of attempts
  • 1 year medical experience to include coding and billing or EMT
  • Ongoing Professional Development with a focus on Insurance
  • Bachelor's degree or higher
  • US military experience through military service or a military spouse/domestic partner
What We Offer

USAA offers a competitive compensation package, including a signing bonus of $2,500 for new hires. We also offer comprehensive medical, dental, and vision plans, 401(k), pension, life insurance, parental benefits, adoption assistance, paid time off program with paid holidays, and various wellness programs.

Applications for this position are accepted on an ongoing basis. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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