2 senior claims examiner jobs found

Pennsylvania Lumbermens Mutual Insurance Company Position: Senior Litigations Claims Examiner Department: Claims Reports To:  Litigations Claims Manager Position Summary: The successful candidate for this position facilitates, coordinates and expedites the handling of all high-severity casualty claims and controls PLM’s largest exposure cases in a prompt, fair and equitable manner. Essential Functions and Responsibilities: Establishes accurate reserves in timely fashion. Determines verification and scope of coverage. Assists other unit members with settlement evaluations. Handles all complicated litigation and ensures trial preparation with attorneys. Attends mediation and settlement conferences. Analyzes insurance contracts. Communicates with the public. Maintains an appropriate diary date on files under direct supervision. Ensures that a file is proceeding towards a prompt, fair and equitable claim settlement. Directs responsibility for supervision of...

The Claims Specialist manages within company best practices lower-level, non-complex and non-problematic workers’ compensation claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims department and of CorVel.  This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Establishes reserves and authorizes payments within reserving authority limits Manages non-complex and non-problematic medical only claims and minor lost-time workers’ compensation claims under close supervision Communicates claim status with the customer, claimant and client Adheres to client and carrier guidelines and participates in claims review as needed Assists other claims professionals with more complex or problematic claims as...