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Claims Examiner II

Claims SpecialistClaims SpecialistOtherRemoteSeniorTeam 1,001-5,000H1B SponsorCompany SiteLinkedIn

Location

United States

Posted

99 days ago

Salary

0

Seniority

Senior

High School5 yrs expEnglish

Job Description

Claims Examiner II

MSI

• Analyzes insurance policies and other documents to determine insurance coverage. • Investigates and analyzes claim information to determine extent of liability. • Handles claims 1st Party Property Claims of a high level of complexity. • Assist in suits, mediations and arbitrations. Works with Counsel in the defense of litigation. • Sets timely, adequate reserves in compliance with the company’s reserving philosophy. • Engages experts to assist in the evaluation of the claim. • Monitors vendor performance and controls expense costs. • Evaluates, negotiates and determines settlement values. • Communicates with all interested parties throughout the life of the claim. Proactively discusses coverage decisions, the need for additional information, and settlement amounts with interested parties. • Handles all claims in accordance with Best Practices. • Responsible for monitoring and completing assigned claims inventory. • Acquire and maintain a state adjuster’s license and meet state continuing education requirements. • Updates and maintains the claim file. • Identifies opportunities for subrogation and ensures recovery interests are protected. • Identifies fraud indicators and refers files to SIU for further investigation. • Participates in claims audits, internal and external. • Provides oversight of TPAs

Job Requirements

  • High School/GED
  • 5-9 years' experience in claims
  • Must have Property & Casualty Insurance License

Benefits

  • Best-In-Class customer service for insureds and agents

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