Claims Examiner ESF1936
Claims Examiner ESF1936
Posted on :
05-04-2025
Employer Active
1 Vacancy
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Yearly Salary
$ 80000 - 115000
Vacancy
1 Vacancy
Posted on :
05-04-2025
Job Description
- Great worklife balance!
- Market leader in commercial insurance and risk management!
- Offer a wide range of career paths and opportunities for growth!
- Competitive Compensation and Benefits: health insurance retirement plans and other benefits!
What you will be doing:
- Investigate and manage workers compensation claims in multiple jurisdictions.
- Handle medical and litigation management to drive claims to closure.
- Coordinate with nurse case managers counsel external vendors and insureds for efficient claims handling.
- Complete and document initial loss investigations to determine compensability.
- Establish initial and subsequent reserves to ensure adequacy for anticipated exposure.
- Review medical bills for causal relationship to reported claims.
- Liaise with insureds nurse case managers and counsel to manage claims and facilitate returns to work.
- Develop and maintain action plans to ensure reserve adequacy and timely resolution of claims.
- Negotiate settlement of claims within designated authority.
- Prepare and present claim review summaries for insureds brokers and internal contacts as requested.
- Participate in roundtable discussions with insureds and counsel on strategies for successful claim closure/resolutions.
- Provide guidance and assistance to insureds and brokers on timely reporting of claims.
- Manage insured onboarding including training on claims reporting and the use of the insured portal.
Experience you will need:
- Bachelor’s degree preferred.
- Professional designation such as CPCU ARM CRM or similar preferred.
- Proficient in Microsoft Office with an aptitude to learn other software applications.
- Excellent oral and written communication skills.
- Detailoriented with a high accuracy rate.
- Strong critical thinking and organizational skills.
- Ability to problem solve and use good judgment.
- Selfmotivated with excellent time management skills.
- 5 years adjusting workers compensation claims in multiple jurisdictions.
- Experience in NY NJ and PA preferred; NY experience required.
- Experience in the healthcare industry preferred.
- Experience in the construction industry preferred.
- 57 years experience as a Workers Compensation loss time claim adjuster.
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Employment Type
Full Time
Key Skills
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