Claim Examiner- WC

2 weeks ago


Livonia, United States Abacus Service Corporation Full time

Department: | SRMS | R | BUS : RM Chicago - Job Category: Claims Job Code: Claim Examiner- WC:BS Job Title: Claim Examiner- WC Keywords: Number of Positions: Remaining Positions: Duties: Receives claim assignment, confirms policy coverages and directs acknowledgement of claims. - Interprets and makes decisions using independent judgment on moderate difficulty claims and policy coverages and determines if coverages apply to claims submitted. - Investigates, evaluates, negotiates and adjudicates first and third party claims to determine validity and verify extent of damage by telephone contact with clients, claimants, witnesses or other parties as required. - Analyzes claims activity and prepares reports for clients/carriers and management. - Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements. - Make settlement decisions promptly and equitably and issues company drafts in payments for claims within authority limits. - Develops subrogation and third party recovery potential and follows reclaim procedures. - Analyzes claims activities and prepares reports for clients, carriers and/or management. Participates in claim reviews. Skills: Ability to work independently while assimilating various technical subjects. - Good verbal or written communication skills. - Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action. - Strong ability to identify, analyze and solve problems. - Effective interpersonal skills to be capable of dealing with external sources and all levels of employees. Education: Bachelor's degree or equivalent experience required. - Comprehensive claims investigations/settling experience - years experience in Claims or similar organization Languages: English Read Write Speak Attachments: Skills and Experience Skills: Required CLIENT COMMUNICATION GREAT ORGANIZATIONAL SKILLS CUSTOMER SERVICE PAYMENTS CLAIMS Additional Languages: English( Speak, Read, Write ) Minimum Degree Required: Also Preferred: Location Client Location Country: United States State/Province: Michigan City: Livonia Address: N Laurel Park DR, Suite Laurel Office Park I, MI POSTAL CODE: Work Location Same as Client Location Other Client Location Work Completed Offsite Schedule Start Date: // Hours Per Week: Est. End Date: // Hours Per Day: Schedule Notes: Days Per Week:



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