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Job DescriptionJob Description SUPERVISION RECEIVED AND EXERCISEDReceives general supervision from the Workers' Compensation Manager and functional supervision from a Senior Claims Examiner.
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Analyzing and reviewing auto insurance claims to identify areas of dispute, investigating and gathering all necessary information and documentation related to the claim, evaluating liability and damages related to the claim, and negotiating and settling claims with opposing parties or their insurance providers.
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Minimum of 3 years of experience in law enforcement or as an insurance claims investigator, Insurance claims examiner, and/or an insurance claims adjustor, or experience as an insurance fraud investigator.
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CERTIFICATIONS/LICENSES : One or more of the following preferred: Active license in good standing to practice law in one or more jurisdictions; Certified Fraud Examiner (ACFE); Certified Insurance Fraud Investigator (CIFI); Chartered Property Casualty Underwriter (CPCU); Self-Insurance Certification (Claims/SIP.
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Minimum three years experience as a medical claims examiner and/or Stop Loss claims auditor. Excess Reinsurance, a market leader in the self-funded medical insurance market, is seeking a full-time claims auditor to join our team.
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The Workers’ Compensation Claims Analyst is responsible for providing superior customer service to policyholders, agents, insurance carrier representatives, and others encountered during general claims handling.
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Communicates effectively with medical providers, the assigned claims examiner, injured worker and policyholder and/or handling attorneys on any given case. The Telephonic Nurse Case Manager will perform clinical assessments and evaluate needs for treatment in worker’s compensation claims.
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Auto-Owners Insurance, a top-rated insurance carrier, is seeking an experienced and motivated claims professional to join our team. Auto-Owners Insurance is an equal opportunity employer.
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The AVP, Sr. Claims Examiner handles all aspects of claims notices and files related to professional liability and accompanying coverages, including but not limited to claims and coverage analysis, liability and damages analysis, reserve setting, reporting, reinsurance analysis and reporting, and travel.
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The Insurance Claims Specialist will be responsible for the daily management and coordination of Workers’ Compensation claims between the third-party claims administrator (TPA) and Operations.
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Auto-Owners Insurance, a top-rated insurance carrier, is seeking a motivated experienced Claims professional to join our team. Review open and closed files to ensure adherence to claim handling guidelines and state's Fair Claims Practices.
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Knowledge of legal entities in private industry, government and non-profit organizations sufficient to determine if they fall under the Unemployment Insurance Law umbrella. Master's degree in Business Administration, Accounting or Finance which include twenty-one (21) credits in accounting or auditing subjects (three (3) of the twenty-one (21) credits in accounting may be in accounting/business law) and two (2) years increasingly responsible professional experience in external/internal auditing, Certified Fraud Examiner (CFE) certification preferred.
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Collaborates with key Senior Leadership (Claims/Medical Management, Underwriting, Premium Audit, Finance, Legal) to refine and maintain SIU best practices and processes to prevent, detect, investigate and ensure timely reporting of suspected fraudulent activity.
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Working under the direct supervision of the Claims Manager within a defined level of authority, the Professional Liability Adjuster must comply with company claims protocols and all applicable laws, including but not limited to state specific Department of Insurance Regulations.
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The auto liability claims department is looking for an experienced Claims Examiner to handle moderate complexity auto claims within our organization. We provide a comprehensive portfolio of commercial property casualty insurance, automobile liability and workers’ compensation, along with claim services, providing expertise to meet the unique business needs of our customers.
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