5 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...

Company Argo Group Argo Group is an underwriter of specialty insurance products in the property and casualty market. Argo offers a full line of products and services designed to meet the unique coverage and claims-handling needs of businesses. The Argo entities are wholly-owned subsidiaries of Clearbrook Group Holdings Inc. Job Description Business Title(s):   Medical Only Claims Adjuster   Employment Type:   Full-Time   FLSA Status:   Non-Exempt   Location:   In-Office     Summary:     We are looking for a highly capable Medical Only Claims   Adjuster to   join our Claims team and work from either our Rockwood, PA , Richmond, VA,   or Omaha, NE offices .    Alternatively, we can also fill this role in our Springfield, MO office.     The position reports to a manager based in Rockwood, PA. The Medical Only Claims Adjuster   is responsible for   managing medical-only claims for...

The Claims Supervisor is responsible for supervising a team of direct reports, ensuring all quality, productivity and customer service criteria are met while adhering to company policies and procedures. The Claims Supervisor position is integral to the success of the company and requires regular and consistent attendance, supporting the goals of the claims department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Supervises claims staff in their day-to-day operations Assists Claims Manager with recruitment, interviewing, and onboarding new staff, ensuring proficiency in procedures and job functions Ensures staff compliance with Workers’ Compensation laws and mandated regulatory reporting requirements Ensures optimal team performance through ongoing training, coaching, and regular performance evaluations; recommends merit-based actions (subject to managerial approval) Provides technical and jurisdictional guidance to claims staff...

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...

The Claims Assistant will support the claims staff in the set-up and administration of workers’ compensation claims/case management and other tasks depending on the specific customer needs.  This is a hybrid role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Sets up new claims Process mail, handle files (until paperless), and input notes/diary entries in the claims system Process payments, as needed Process form letters, state forms and reports Assist claims examiners with telephone calls including provider, claimant and customer calls Additional duties as assigned   KNOWLEDGE & SKILLS: Excellent written and verbal communication skills PC literate, including Microsoft Office (Word, Excel) Ability to work independently and in a team environment Strong organizational skills   EDUCATION & EXPERIENCE:  High school diploma, college degree preferred Six (6) months of service oriented office...