3 case manager jobs found in Edmeston

EFW Examiners review claims for red flag indicators that will determine if further investigation and referral to special investigation unit (SIU) is needed. They also collaborate with examiners, supervisors and EFW examiners to reach mutual decisions on the disposition of claims that have been investigated. Duties & Responsibilities: Collaborate with the examiner teams to identify claims in need of further investigation. Work with examiners, customers, vendors, and other resources to gather information to establish facts of loss and if potential fraud indicators exist. Conduct objective, fair, thorough, and timely investigations, and reviews. Ensure processing of the claims are handled in accordance with regulation time frame. Submit claims to SIU through the database for assist or referral when fraud indicators are present. Return to examiner for normal claim processing when all red flag indicators have been ruled out. Generate detailed denials based on...

The Physical Damage Business Unit Manager provides tactical leadership to the development teams of the Physical Damage and Subrogation of the Auto Claim division. The incumbent is responsible for the daily operations of the business unit and assists the Division Manager in defining the Strategic direction of claim settlement within the culture of NYCM Insurance. The Physical Damage Business Unit Manager must demonstrate expert knowledge of the positions within the Division and is ultimately responsible for the decisions made by the Supervisors and any other direct reports within the Division.  Ensures compliance with best practice and regulatory standards through regular review and coaching; provides evaluation guidance; works with division partners (supervisory teams and division management) to fulfill performance objectives and reporting; develops and executes assigned action plans. Duties & Responsibilities: Assists the Division Manager in carrying out the...

The Property Examiner (Inhouse) evaluates first and third-party property claims to determine coverage and damages based upon sound claim knowledge. They manage the claim process, including coverage verification, investigation, evaluation and disposition of the claim in compliance with applicable insurance regulations and NYCM’s best practices. They assess and ensure the customer’s needs and expectations of the claim process are met. Duties & Responsibilities: Compile reports for management review. Issue settlement payments within the scope of coverage and authority. Effectively communicate and establish connections with the customers during the claim process. Professional handling of incoming and outgoing customer phone calls. Professional written communications such as emails, requests for information or coverage letters. Guide customers, including claimants, through the claim process, ensuring that they are informed at all stages. Manage customer...