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Claim Examiner- WC

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TalentBurst

2024-11-05 04:40:17

Job location Lake Zurich, Illinois, United States

Job type: fulltime

Job industry: Insurance & Superannuation

Job description


Claim Examiner- WC
Location : 1 Corporate Drive, Suite 120, Lake Zurich, IL 60047
Pay rate : $30.51
Duration : 2 Months+
100 % REMOTE
HM Notes : Must have experience handling IL WC claims


Job Description:
Receives claim assignment, confirms policy coverages and directs acknowledgement of claims
- Interprets and makes decisions using independent judgment on moderate difficulty claims and policy coverages and determines if coverages apply to claims submitted
- Investigates, evaluates, negotiates and adjudicates first and third party claims to determine validity and verify extent of damage by telephone contact with clients, claimants, witnesses or other parties as required
- Analyzes claims activity and prepares reports for clients/carriers and management
- Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements
- Make settlement decisions promptly and equitably and issues company drafts in payments for claims within authority limits
- Develops subrogation and third party recovery potential and follows reclaim procedures
- Analyzes claims activities and prepares reports for clients, carriers and/or management
Participates in claim reviews

Skills:
Ability to work independently while assimilating various technical subjects
- Good verbal or written communication skills
- Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action
- Strong ability to identify, analyze and solve problems
- Effective interpersonal skills to be capable of dealing with external sources and all levels of employees

Education:
Bachelor's degree or equivalent experience required
- Comprehensive claims investigations/settling experience 1-3 years experience in Claims or similar organization.

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