Claims Examiner

This Jobot Job is hosted by: Jerome Ouvier

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Salary: $80,000 - $120,000 per year

Client specializes in underwriting, insurance coverage for small businesses in a specific niche market. Insurance policies include GL, PL, Property & Casualty etc.

Competitive salary and performance-based incentives.

Comprehensive health, dental, and vision insurance plans.

401(k) retirement plan with company match.

Generous paid time off and holiday schedule.

Employee wellness programs and resources.

We are seeking a highly skilled and detail-oriented Specialty Claims Examiner to join our dynamic team. The ideal candidate will have a strong background in claims examination, with a focus on specialty insurance products. This role requires exceptional analytical skills, a thorough understanding of insurance policies, and the ability to navigate complex claims with professionalism and empathy.

Key Responsibilities:

Claims Evaluation: Review and analyze claims to determine coverage, liability, and damages. Ensure all claims are handled in accordance with company policies and regulatory requirements.

Documentation and Reporting: Accurately document claim investigations, findings, and decisions. Prepare comprehensive reports for internal and external stakeholders.

Customer Interaction: Communicate effectively with policyholders, claimants, and legal representatives. Provide clear and concise explanations of coverage, claim status, and settlement options.

Fraud Detection: Identify potential fraudulent claims and conduct thorough investigations to mitigate risk. Collaborate with the Special Investigations Unit (SIU) as necessary.

Negotiation and Settlement: Negotiate fair and equitable settlements with claimants and their representatives. Ensure timely and accurate processing of claim payments.

Continuous Improvement: Stay current with industry trends, regulations, and best practices. Participate in ongoing training and development to enhance expertise in specialty claims.

Qualifications:

Bachelor’s degree in Business, Insurance, or a related field.

Minimum of 5 years of experience in claims examination, with a focus on specialty insurance products.

Strong analytical and problem-solving skills.

Excellent written and verbal communication abilities.

Proficiency in claims management software and Microsoft Office Suite.

Ability to work independently and as part of a team in a fast-paced environment.

Exceptional attention to detail and organizational skills.

Professional certifications such as AIC, CPCU, or similar are a plus.

Interested in hearing more? Easy Apply now by clicking the "Apply Now" button.