Title: Claims Examiner - Liability
Location: Irving, TX 75063
Term: 5 Months Contract
- Manages mid-level general liability claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
- Assesses liability and resolves claims within evaluation.
- Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
- Manages subrogation of claims and negotiates settlements.
- Communicates claim action with claimant and client.
- Ensures claim files are properly documented and claims coding is correct.
- May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
- Travels as required.
- Maintains professional client relationships.
Is this a good fit? (Requirements):
- 4 years of claims management experience or equivalent combination of education and experience required.
- Bachelor's degree from an accredited college or university preferred.
- Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Good interpersonal skills
- Excellent negotiation skills
- Ability to work in a team environment
- Ability to meet or exceed Service Expectations
- Experienced Bodily Injury Claims Representatives or Examiner level adjusters
- Experience with handling 3rd party automobile liability claims with injuries (sometimes severe injurie) or highly complex and litigated claim files
- Must be licensed (mandatory)
- no less than 15 years’ experience in handled liability claims
If this sounds like the perfect fit, Apply Today!