Insurance Claims Evaluator

2 weeks ago

Durham, North Carolina, United States City of Durham, NC Full time
Salary: $65,101,920.00 Annually

Location: Durham, NC

Job Type: Full time with benefits

Remote Employment: Flexible/Hybrid

Department: Finance

Position Overview

Join the City of Durham and Make an Impact
Advance your career while contributing positively to the community.

Hiring Range: $65,800
Hours/Schedule: M-F 8:00 - 5:00

As part of one of the most financially sound municipalities in the nation, the City of Durham emphasizes responsible management of public funds. Our Finance Department leads risk management efforts, ensuring effective administration and training to safeguard taxpayer interests.

This role is situated within the Risk Management Division, which is dedicated to fostering a secure environment for both employees and the public. The primary aim is to mitigate financial losses and reduce the occurrence and severity of injuries. The selected candidate will be responsible for evaluating and processing property and casualty claims, managing self-insured fiscal responsibilities, and implementing loss prevention strategies. Key responsibilities include making informed decisions regarding risk management goals, enhancing claim filing processes, and conducting data analysis for liability assessments. Candidates should demonstrate professional expertise in handling auto and general liability claims, including property damage and bodily injury. Experience in municipal insurance program management is advantageous but not mandatory.

Key Responsibilities
  • Investigate, assess, and determine liability for incidents involving property damage and bodily injury.
  • Supervise the City's third-party claims administrator and assigned claims adjusters.
  • Establish and streamline claim reporting and processing protocols.
  • Maintain accurate documentation of claims, set reserves, and manage claim payments through designated risk management software.
  • Identify subrogation opportunities and initiate necessary actions, including preparing demand packages and ensuring proper follow-up until claim resolution.
  • Collaborate with the Risk Manager and City Attorney's Office to manage claim litigation and participate in settlement discussions.
  • Provide analytical reports to the Risk Manager regarding claim trends, expenditures, and subrogation recoveries.
  • Engage in accident review boards.
  • Deliver training to City personnel on effective claim reporting practices and general risk management principles.
  • Assist the Risk Manager and team members with special projects and additional tasks as required.
Minimum Qualifications & Experience
  • Bachelor's degree in business, public administration, or a closely related field.
  • Two years of relevant professional experience.
Preferred Skills

  • NC Adjuster License or willingness to obtain within one year of employment.
  • Experience with governmental immunity.
  • Familiarity with litigation management.
  • Advanced proficiency in MS Office, especially Excel.
  • Experience in providing in-person training.
  • AIC or similar insurance designation.
Benefits for Full-Time Employees
  • 11-12 paid holidays annually.
  • 12 days of vacation per year.
  • 12 days of sick leave per year, accumulating indefinitely.
  • Medical, dental, vision, and supplemental life insurance options.
  • Retirement plans through State and City.
  • Short and long-term disability coverage.
  • Employee Assistance Program for personal and family counseling.
  • Paid life insurance equivalent to annual salary.

  • Insurance Claims Evaluator

    2 weeks ago

    Durham, North Carolina, United States City of Durham Full time

    Position OverviewThe City of Durham is seeking a dedicated Liability Claims Analyst to join our Finance Department. This role is essential in ensuring the effective management of liability claims and fostering a safe environment for both employees and the public.Key ResponsibilitiesEvaluate and process claims related to property damage and bodily injury...

  • Experienced General Liability Claims Examiner

    1 week ago

    Durham, North Carolina, United States King's Insurance Staffing Full time

    Position Overview:King's Insurance Staffing is seeking a highly skilled Senior Commercial General Liability Claims Specialist to enhance our team. This role involves managing a portfolio of moderate to complex Commercial General Liability claims, including incidents such as Slip and Falls, Premise Liability, and Bodily Injury cases across various...

  • Senior Liability Claims Examiner

    1 week ago

    Durham, North Carolina, United States King's Insurance Staffing Full time

    Position Overview:King's Insurance Staffing is seeking a highly skilled Senior Commercial General Liability Claims Examiner to enhance our team. This role involves managing a diverse portfolio of moderate to complex Commercial General Liability claims, including but not limited to Slip and Falls, Premise Liability, and Bodily Injury incidents.Key...

  • Liability Claims Specialist

    2 weeks ago

    Durham, North Carolina, United States City of Durham, NC Full time

    Salary: $65,101,920.00 Annually Location: Durham, NC Job Type: Full time with benefits Remote Employment: Flexible/Hybrid Department: Finance Position OverviewJoin the City of Durham and Make an ImpactAdvance your career while contributing positively to the community. Hiring Range: $65,800 Hours/Schedule: M-F 8:00 - 5:00 Become part of a highly regarded...

  • Claims-Field Auto Adjuster I, II, or Sr

    1 month ago

    Durham, North Carolina, United States Allstate Insurance Company Full time

    National General is a part of The Allstate Corporation, which means we have the same innovative drive that keeps us a step ahead of our customers evolving needs. We offer home, auto and accident and health insurance, as well as other specialty niche insurance products, through a large network of independent insurance agents, as well as directly to...

  • Healthcare Billing Specialist

    2 weeks ago

    Durham, North Carolina, United States REVCO SOLUTIONS INC Full time

    Position OverviewAbout Us:At Revco Solutions Inc, we are dedicated to delivering exceptional Revenue Cycle Management services to healthcare providers, ensuring the financial health of our clients in the medical sector.Key Responsibilities:Evaluate, investigate, and prepare insurance claims for submission to various insurance providers, including both...

  • Commercial Lines Account Professional

    5 days ago

    Durham, North Carolina, United States McGriff Insurance Services Full time

    Job Summary:McGriff Insurance Services is seeking a highly skilled Insurance Account Manager to join our team. As an Insurance Account Manager, you will be responsible for building and maintaining key client and carrier relationships, providing exceptional customer service, and identifying opportunities to cross-sell and upsell our products.Key...

  • Patient Financial Advisor

    2 weeks ago

    Durham, North Carolina, United States Duke Health Full time

    Patient Financial Advisor Duke University Health System - Patient Revenue Management Office (PRMO) is in search of a Patient Financial Advisor who will meticulously manage patient accounts and ensure compliance with all insurance protocols. This position entails evaluating insurance plans, securing necessary authorizations, clarifying billing statements...

  • Patient Financial Advisor

    2 weeks ago

    Durham, North Carolina, United States Duke Health Full time

    Patient Financial Advisor Duke University Health System - Patient Revenue Management Office (PRMO) is in search of a Patient Financial Advisor who will meticulously manage patient accounts and ensure compliance with all insurance protocols. This position entails evaluating insurance plans, securing necessary authorizations, clarifying billing statements...

  • Clinical Trials Revenue Integrity Specialist

    2 weeks ago

    Durham, North Carolina, United States Duke University Full time

    About Duke HealthAt Duke Health, our mission is to provide compassionate care that transforms the lives of patients and their families, as well as the broader community. We are dedicated to advancing health through collaboration and innovation.Overview of the Patient Revenue Management OrganizationThe Patient Revenue Management Organization (PRMO) is a fully...

  • Clinical Trials Revenue Analyst

    1 week ago

    Durham, North Carolina, United States Duke University Full time

    OverviewAt Duke Health, our mission is to provide compassionate care that positively impacts patients, their families, and the broader community. We are committed to advancing health through collaboration and innovation.About the Patient Revenue Management OrganizationThe Patient Revenue Management Organization (PRMO) at Duke Health is a comprehensive,...

  • Health Insurance Sales Representative

    3 days ago

    Durham, North Carolina, United States WallStJobs Full time

    Job OverviewWallStJobs is seeking a dynamic and motivated Health Insurance Agent to join their team. As a leading provider of comprehensive insurance solutions, we are committed to delivering exceptional customer experiences and building long-lasting relationships with our clients.Key ResponsibilitiesIdentify and engage with potential clients through...

  • Financial Care Specialist

    15 hours ago

    Durham, North Carolina, United States Duke University Full time

    About the RoleWe are seeking a highly skilled and detail-oriented Financial Care Counselor to join our Patient Revenue Management Organization at Duke University Health System. As a key member of our team, you will play a critical role in ensuring the accurate and efficient processing of patient accounts, while providing exceptional customer service to our...

  • Financial Care Specialist

    3 days ago

    Durham, North Carolina, United States Duke University Full time

    About the RoleWe are seeking a highly skilled and detail-oriented Financial Care Specialist to join our team at Duke University. As a key member of our Patient Revenue Management Organization, you will play a critical role in ensuring the accurate and timely processing of patient accounts.Key ResponsibilitiesAnalyze insurance coverage and benefits to ensure...

  • Financial Care Specialist

    3 days ago

    Durham, North Carolina, United States Duke University Full time

    About the RoleWe are seeking a highly skilled and detail-oriented Financial Care Specialist to join our team at Duke University. As a key member of our Patient Revenue Management Organization, you will play a critical role in ensuring the accurate and efficient processing of patient accounts.Key ResponsibilitiesAnalyze insurance coverage and benefits to...

  • Financial Care Specialist

    1 week ago

    Durham, North Carolina, United States Duke Health Full time

    Job SummaryDuke Health is seeking a skilled Financial Care Specialist to join our team in the Patient Revenue Management Office (PRMO). As a key member of our team, you will play a critical role in ensuring accurate and timely completion of patient accounts, while also ensuring compliance with all insurance requirements.Key ResponsibilitiesAnalyze patient...

  • Financial Care Specialist

    3 days ago

    Durham, North Carolina, United States Duke University Full time

    About the RoleWe are seeking a highly skilled and detail-oriented Financial Care Specialist to join our Patient Revenue Management Organization at Duke University Health System.Key ResponsibilitiesAnalyze patient insurance coverage and benefits to ensure timely and accurate billing.Obtain authorizations and process payments in accordance with insurance plan...

  • Clinical Trials Revenue Integrity Specialist

    2 weeks ago

    Durham, North Carolina, United States Duke University Full time

    OverviewAt Duke Health, our mission is to provide compassionate care that positively impacts patients, their families, and the broader community. We invite you to explore how your skills can contribute to advancing health outcomes. About the Patient Revenue Management OrganizationThe Patient Revenue Management Organization (PRMO) is a comprehensive,...

  • Financial Care Specialist

    2 days ago

    Durham, North Carolina, United States Duke Health Full time

    About the RoleWe are seeking a highly skilled and detail-oriented Financial Care Specialist to join our team at Duke Health. As a key member of our Patient Revenue Management Organization (PRMO), you will play a critical role in ensuring the accurate and efficient processing of patient accounts.Key ResponsibilitiesAnalyze insurance coverage and benefits to...

  • Clinical Staff Pharmacist

    5 days ago

    Durham, North Carolina, United States Veterans Affairs, Veterans Health Administration Full time

    Job SummaryThis Clinical Staff Pharmacist position is located within the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), VA Mid-Atlantic Health Care Network (VISN 6), Durham, NC Veterans Affairs Medical Center under the Pharmacy Service Line.This position can be assigned to work in any section of the pharmacy service and must be...