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The Opportunity As a dedicated injury examiner, you will adjust complex bodily injury claims and UIM claims to include confirming coverage, determining liability, investigating, evaluating, negotiating, defending, and settling claims in compliance with state laws and regulations.
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In addition, the Sr. Claims Examiner will be responsible for recognizing claims involving coverage issues and bring to the Claims and Coverage Committees for referral to counsel. Overview Responsible for managing complex liability claims, employment & civil rights claims to their conclusion in the most cost-effective way possible for the client.
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In this role you will manage complex general liability and auto liability claims, both litigated and non-litigated, under primary and excess Personal Lines policies. Adhere to individual authority grants, all statutory and regulatory requirements, fair claim practices and local compliance requirements, including examiner licensing.
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Responsibilities include: Handle General Liability / Bodily Injury, Property, Commercial Auto Liability and/or Physical Damage, Workers Compensation, Inland Marine, Professional / Management Liability, Business Interruption, Liquor Liability, Garage/Garagekeepers Legal Liability or Umbrella claims.
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Adjudicate all claims types including Dental, Vision and Medical claims for inpatient and outpatient facilities, physician claims, In and Out of Network claims, Medicaid reclamation (HIPD), FSA, foreign claims, outpatient lab and radiology, accident and Third-Party Liability (TPL) claims, and Medicare Secondary Payer (MSP) by calculating benefit due to approve or deny, based on SPD.
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The Senior Claims Examiner will work on special projects related to provider and plan documents, system upgrades, implementing initiatives to improve claims processing, and turnaround times. TheSenior Claims Examiner will process large dollar/complex health care claims, adjustments and contracts that require higher degree of accuracy.
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This person would be responsible for handling moderate to complex Auto Liability and Bodily Injury claims for losses throughout the Mid-Atlantic region. 4 to 10+ years of Personal and/or Commercial Auto Liability claims experience.
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WHAT WE ARE SEEKING We have assignments available to help our insurance carrier or Third-Party Administrator (TPA) clients in Property & Casualty (P&C) Commercial Claims Adjuster or Examiner positions.
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Experience interpreting and applying Federal tax law to determine the correct tax liability from filed and/or non-filed returns as it applies to Federal, State and Local Governments and related employment tax issues.
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High school education or equivalent and five (5) to seven (7) years of experience as a health claims examiner or comparable industry experience. Advance level (minimum 5 years) of claims processing experience and understanding of medical, dental, FSA, HRA, transplant, coordination of benefits, Medicare, hospital, professional, subrogation, and accident claims required.
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Current HIGH DEMAND for licensed Bodily Injury, Professional Liability or Medical Malpractice claim experience. P&C Commercial Claims Adjuster - Carrier or TPA - REMOTE Put your Insurance Experience to work - FROM HOME At Wahve, we value significant insurance experience and want to revolutionize the way people think about phasing into retirement by offering qualified candidates the opportunity to continue their career working from home.
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Claims Examiner - Liability. PRIMARY PURPOSE OF THE ROLE: To analyze high-level General Liability claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
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Minimum of five (5) years of experience as Senior Claims Examiner required and two (2) years-experience as a Workers’ Compensation Claims Supervisor, preferred. Keenan specializes in providing consulting services in the areas of: employee benefits, workers' compensation, loss control, financial, and property & liability.
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Litigation and Subrogation experience highly desired. Customize your schedule - full or part time. Review police reports, legal and medical bills, etc. Be part of our dynamic yet virtual team environment and connect with other experienced insurance professionals like yourself HOW TO GET STARTED Click APPLY NOW to complete our simple preliminary profile.
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Set Reserves and draft Reservation of Rights letters - preferred. Our unique platform provides you with real work/life balance and allows you to customize your own work schedule while continuing to utilize your insurance expertise in a remote, long-term position.
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