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10+ years’ experience with complex liability claims and or litigation at a TPA or risk management department. This role reports to the Director of Liability Claims and works with the risk management team to develop the claim program policies, and procedures for: reporting, investigation, and analysis; litigation management; resolution/outcome management; and the delivery of claim information.
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Our defense practice specializes in workers’ compensation, subrogation, wrongful termination, professional athlete injury defense, fraud claims, insurance coverage issues, and Longshore and Harbor claims.
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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) Claims Adjuster or Examiner positions.
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Collaborates with Provider Relations and other provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations (claims and encounters). Educates providers and supports provider practice sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment.
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At Pinnacle Claims Management, we are an innovative third-party administrator (TPA) that provides a full-suite of comprehensive and customized health benefits administration services for self-funded companies, including health management and wellness solutions, and pharmacy benefit management.
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Most surveys are focused on assessing thebusiness for Property and General Liability coverage, but we also service other commercialinsurance lines of business including Workers Compensation, Auto/Fleet, Products Liability,Inland Marine and Builders Risk. All interested candidates are encouraged to apply.
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At Capital One, you will be a vital contributing member to a tiger team responsible for identifying cybersecurity gaps and seams and solutions on how to address them, to include highlighting the need for new or enhanced projects that create business value and reduce critical cyber risk.
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These initiatives are designed to minimize exposure to the expense and potential loss of business associated with employee injury, liability claims, building damage, loss of physical assets or business interruption due to fire or natural disasters, environmental issues, and regulatory compliance issues.
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Qualifications:Minimum of 1 year experience as a workers compensation claims adjuster. As a Work Comp Adjuster, you will be responsible for investigating, evaluating, negotiating, and settling workers compensation claims on behalf of our clients.
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Bring your passion for helping others to our team and well teach you the insurance stuff providing in-depth training on property damage and insurance contracts so you can confidently and independently adjust claims.
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JOB DESCRIPTION :Essential Duties & Responsibilities:Performs a combination of duties in accordance with departmental guidelines:Manages an inventory of the most complex and high exposure Lawyers Professional Liability Claims by following company protocols to manage and oversee all aspects of the claim handling, including coverage determinations, investigations, and resolution strategies which may include pursuit of risk transfer, extensive negotiations and complex litigation management.
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Must have or be able to obtain and maintain an Insurance Adjuster License within 90 days of hire, where applicable. Reporting RelationshipTypically Director or aboveSkills, Knowledge & AbilitiesExpert knowledge of the professional services industry, ideally Lawyers Professional Liability claims, policy language, coverage, and claim practices.
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Commercial Insurance Inspector- (Roanoke / Blacksburg, VA.) Blacksburg, VA, USA ● Roanoke, VA, USA Req #26766 Wednesday, July 10, 2024 The CompanyCommercial and personal line insurance carriers rely on EXL as a key business partner through our Castle High Value and EXL Risk Control service offerings.
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RCM Analyst | Revenue Cycle Billing Specialist | Insurance Specialist | Revenue Cycle Claims Specialist | Medical Billing Specialist | Revenue Cycle AR Collections Specialist | Billing and Reimbursement Specialist | Billing Specialist |Billing Coordinator | Claims Specialist | Billing Representative | Collections Specialist | ABA Billing Specialist | ABA Claims Specialist | Behavioral Health Billing Specialist.
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Drives the resolution of claims by collaborating with internal and external business partners to develop, own and execute a claim resolution strategy, that includes management of timely and adequate reserves, collaborating with coverage experts, negotiating complex settlements, partnering with counsel to manage complex litigation and authorizing payments within scope of authority.
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tpa compensation claims risk insurance jobs Company: Deloitte
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