Claims Examiner

This Jobot Job is hosted by: Jerome Ouvier

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Salary: $90,000 - $110,000 per year

Client is a leading global insurance organization!

Competitive salary

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 searching for a highly skilled and professional Claims Examiner who will be responsible for managing, investigating, and resolving claims. The successful candidate will be tasked with analyzing and reviewing claims for accuracy, completeness, and eligibility. They will also be responsible for preparing reports, maintaining accurate records, and coordinating with legal counsel. This role is vital in ensuring that claims processes are carried out efficiently and that the company’s reputation is safeguarded against fraudulent claims.

Responsibilities:

1. Conduct thorough, detailed investigations into claims to determine validity and assess potential risks.
2. Utilize your expertise in TPA Analysis to assess third party administrators and their claims processing capabilities.
3. Exhibit proficiency in the fraud process, identifying suspicious activity, and implementing procedures to prevent fraud.
4. Collaborate with the Claims Recovery team to ensure the effective recovery of claim costs.
5. Prepare and present detailed reports on investigations, findings, and claim status.
6. Coordinate with legal counsel on claims requiring litigation.
7. Maintain accurate and up-to-date claim records.
8. Stay current with the latest industry trends, techniques, and methods related to claim examination and fraud detection.
9. Implement strategies to mitigate losses and protect the company’s financial interests.

Qualifications:

1. Bachelor's degree in Business Administration, Finance, or related field.
2. A minimum of 5 years of experience as a Claims Examiner, Claims Fraud Investigator, or similar role in the Mortgage industry.
3. Proven experience with TPA Analysis and Claims Recovery.
4. Excellent knowledge of the fraud process and experience in identifying and preventing fraudulent claims.
5. Strong analytical skills with the ability to interpret and process large amounts of data.
6. Exceptional attention to detail and accuracy.
7. Excellent verbal and written communication skills.
8. Strong organizational and multitasking skills.
9. Proficient in Microsoft Office Suite and claims management software.
10. Ability to work independently and as part of a team.
11. Certified Fraud Examiner (CFE) or similar certification would be an advantage.

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