Claim Examiner- WC - Hornet Staffing : Job Details
Claim Examiner- WC
Hornet StaffingJob Location : Lake Zurich,IL, USA
Posted on :
2024-11-13T08:41:29Z
Job Description :
Description:
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- 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.
- 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.
- 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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