92 claims examiner i jobs found

Overview The Senior Claims Examiner I, CA is responsible for prompt efficient review and disposition of insurance claims through effective research, evaluation, investigation, negotiation and interaction with insureds or claimants. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of the AmTrust and Claims organization. Responsibilities Investigates the claim or coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured or employer representatives, claimants or injured workers, witnesses and producers. Determines, reviews and analyzes coverage. While operating autonomously, elevates coverage issues as needed with appropriate resources and drafts positions as required. Responsible for setting of timely and accurate reserves based on facts, company standard and experience. Establishes effective litigation...

Overview The Lead Claims Examiner is responsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of AmTrust and the Claims organization.   This position will start remotely with an expectation to transition to a hybrid schedule upon opening of our Overland Park, Kansas office. Responsibilities Follows AmTrust policies and procedures in managing claims. Investigates the claim and coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured, claimant, witnesses and medical providers. Evaluates, establishes, maintains and adjusts reserves based on fact, company standard and experience. Skillfully...

Company Details     As an elite Excess and Surplus Lines market, Nautilus Insurance Group offers commercial property and casualty insurance solutions to appointed wholesale surplus lines producers countrywide. We have specialized in providing these solutions for more than 35 years.   We have more flexible policy terms and premium rates on a non-admitted basis. Our focus is small to medium Property and Casualty risks on both an admitted and a non-admitted basis.   Our offerings are distributed through partnerships with appointed wholesale surplus lines producers. Our relationships are defined by mutual success, speed to market, customer-centric focus and an expanded appetite.   Coverage placed by Nautilus Insurance Group is provided by Nautilus Insurance Company and Great Divide Insurance Company, both W. R. Berkley Corporation members with A.M. Best (Superior) A+ XV ratings.   Benefit Highlights :  Paid Parental Leave! At...

Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned* The Claims Examiner I obtains and analyzes data for thorough, fair, objective, and timely processing of New York State statutory Short-Term Disability and Paid Family leave claims.   The goal of the position/role is to consistently pay the accurate amount for each claim in accordance with the current laws/regulations. Research Develop an understanding and working knowledge of disability and paid family leave Develop an understanding of the applicable claim definitions and relevant provisions, clauses, exclusions, riders and waivers for the necessary requirements. Develop an operating knowledge of the applicable claims system(s). Develop basic claims skills and an understanding of claim practices and procedures. Utilizes most efficient means to obtain claim information. Analysis and Adjudication Fully investigates all relevant claim issues with oversight by Manager when...

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview Investigate, evaluate, provide defense if appropriate, negotiate and resolve assigned property damage and bodily injury claims reported under affiliated Companies' insurance contracts, in accordance with those contracts and applicable law, within documented authority. What will you do? CLAIM INVESTIGATION: Investigate assigned claims reported under insurance contracts provided by affiliated Companies, including identification of information and documents needed to evaluate claims, assignment and direction of independent adjusters and review of public and other records and documents. Contact...

Company: NICO National Indemnity Company Want to work for a company with unparalleled financial strength and stability that offers “large company” benefits with an exciting, friendly, and “small company” atmosphere?  Our companies, as members of the Berkshire Hathaway group of Insurance Companies, provides opportunities for professionals interested in just that.   A Brief Overview Investigate, evaluate, provide defense if appropriate, negotiate and resolve assigned property damage and bodily injury claims reported under affiliated Companies' insurance contracts, in accordance with those contracts and applicable law, within documented authority. What will you do? CLAIM INVESTIGATION: Investigate assigned claims reported under insurance contracts provided by affiliated Companies, including identification of information and documents needed to evaluate claims, assignment and direction of independent adjusters and review of public and other records and documents. Contact...

What part will you play? If you’re looking for a place where you can make a meaningful difference, you’ve found it. The work we do at Markel gives people the confidence to move forward and seize opportunities, and you’ll find your fit amongst our global community of optimists and problem-solvers. We’re always pushing each other to go further because we believe that when we realize our potential, we can help others reach theirs. Join us and play your part in something special! This position will be responsible for the resolution of claims of average complexity and low to mid exposure claims. The primary purpose of this job is to investigate, evaluate, negotiate and settle assigned claims by collecting and analyzing data according to policy application and/or contract provisions. The position will have responsibility for decision making within their authority and work under the general direction from their manager. Confirms coverage of claims by reviewing policies and...

How You Will Contribute Investigate, evaluate, and resolve casualty claims in accordance with company policies and applicable laws. Determine coverage, liability, and damages through thorough analysis and documentation. Communicate effectively with policyholders, claimants, attorneys, and other stakeholders. Maintain accurate and timely claim files and documentation. Collaborate with internal teams to ensure efficient claim resolution. Negotiate Auto Material Damage and other Property Damage claims as a result of liability related to the Casualty Claim file.  What You Bring to the Table Strong working knowledge of policy language and interpretation. Expertise in claims settlement principles and practices. Familiarity with medical technology, law, repair techniques, and auto estimating. Clear and concise communication skills, both written and oral. Planning and organizational skills. Ability to analyze situations, solve problems, and make decisions....

Overview AmTrust Financial Services is growing fast and looking for a Claims Examiner I to join our Workers’ Compensation team. You’ll investigate and resolve claims quickly and accurately, using strong research and negotiation skills to deliver great results. Prior insurance experience— even outside workers’ comp or commercial lines.   This role is hybrid out of our Scottsdale, AZ office Responsibilities Assist in reviewing, investigating, and processing incoming claims in accordance with company policies and regulatory guidelines. Gather and analyze documentation, statements, and other supporting materials to determine claim validity and coverage. Communicate with policyholders, vendors, and internal teams to ensure timely and accurate claim resolution. Maintain detailed and accurate claim files and documentation. Provide clear, empathetic, and professional customer service throughout the claims process....

Overview AmTrust Financial Services is growing fast and looking for a Claims Examiner I to join our Workers’ Compensation team. You’ll investigate and resolve claims quickly and accurately, using strong research and negotiation skills to deliver great results. Prior insurance experience— even outside workers’ comp or commercial lines— and an adjuster license are preferred.   This role is hybrid out of our South Jordan, UT office Responsibilities Assist in reviewing, investigating, and processing incoming claims in accordance with company policies and regulatory guidelines. Gather and analyze documentation, statements, and other supporting materials to determine claim validity and coverage. Communicate with policyholders, vendors, and internal teams to ensure timely and accurate claim resolution. Maintain detailed and accurate claim files and documentation. Provide clear, empathetic, and professional customer...

Overview AmTrust Financial Services is growing fast and looking for a Claims Examiner I to join our Workers’ Compensation team. You’ll investigate and resolve claims quickly and accurately, using strong research and negotiation skills to deliver great results. Prior insurance experience— even outside workers’ comp or commercial lines.   This role is hybrid out of our Maitland, FL office Responsibilities Assist in reviewing, investigating, and processing incoming claims in accordance with company policies and regulatory guidelines. Gather and analyze documentation, statements, and other supporting materials to determine claim validity and coverage. Communicate with policyholders, vendors, and internal teams to ensure timely and accurate claim resolution. Maintain detailed and accurate claim files and documentation. Provide clear, empathetic, and professional customer service throughout the claims process....

Overview AmTrust Financial Services is growing fast and looking for a Claims Examiner I to join our Workers’ Compensation team. You’ll investigate and resolve claims quickly and accurately, using strong research and negotiation skills to deliver great results. Prior insurance experience— even outside workers’ comp or commercial lines— and an adjuster license are preferred.   This role is hybrid out of our Overland Park, KS office Responsibilities Assist in reviewing, investigating, and processing incoming claims in accordance with company policies and regulatory guidelines. Gather and analyze documentation, statements, and other supporting materials to determine claim validity and coverage. Communicate with policyholders, vendors, and internal teams to ensure timely and accurate claim resolution. Maintain detailed and accurate claim files and documentation. Provide clear, empathetic, and professional customer...

Overview The Lead Claims Examiner is responsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of AmTrust and the Claims organization. Responsibilities Follows AmTrust policies and procedures in managing claims. Investigates the claim and coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured, claimant, witnesses and medical providers. Evaluates, establishes, maintains and adjusts reserves based on fact, company standard and experience. Skillfully negotiates claims, turning adverse perspectives into quick resolution. Gains trust of other parties to negotiations and demonstrates good sense of timing....

Overview The Lead Claims Examiner is responsible for prompt and efficient investigation, evaluation and settlement or declination of insurance claims through effective research, negotiation and interaction with insureds, claimants and medical providers. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of AmTrust and the Claims organization. Responsibilities Follows AmTrust policies and procedures in managing claims. Investigates the claim and coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured, claimant, witnesses and medical providers. Evaluates, establishes, maintains and adjusts reserves based on fact, company standard and experience. Skillfully negotiates claims, turning adverse perspectives into quick resolution. Gains trust of other parties to negotiations and demonstrates good sense of timing....

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an immediate need for a Senior Claims Examiner - WC .    The adjuster is responsible for the prompt and efficient examination, investigation, settlement or declination of worker’s compensation insurance claims through effective research, negotiation and interaction with insures, and claimants, ensuring that company resources are utilized in a cost-effective manner in the process. The adjuster reports to a WC Supervisor.  Responsibilities Thoroughly investigating workers’ compensation claims by contacting injured workers, medical providers, and employer representatives. Determining if claims are valid under applicable workers’ comp statutes. Communicating with medical providers to develop and authorize appropriate treatment plans. Reviewing and analyzing medical bills to confirm charges and treatment are workers’ comp injury-related and...

Overview AmTrust is actively seeking a skilled Resolution Examiner specializing in Workers' Compensation Claims. The  primary focus will be on negotiating and settling claims efficiently and at a cost effective value. In this role, you will be entrusted with the independent review and resolution of workers' compensation claims; utilizing your expertise in negotiation and settlement strategies to bring claims to resolution posture. Your ability to effectively interact with insureds, claimants, and their legal representatives will be essential in driving timely settlements while adhering to AmTrust’s mission, vision, and values. Responsibilities   Proactively negotiate settlements for workers' compensation claims, ensuring fair and expedient resolutions that meet the needs of all parties involved. Conduct thorough investigations by engaging with insured representatives, claimants, and witnesses to gather critical information...

Overview AmTrust Financial Services, a fast-growing commercial insurance company, has an immediate need for a Senior Claims Examiner - WC .    The adjuster is responsible for the prompt and efficient examination, investigation, settlement or declination of worker’s compensation insurance claims through effective research, negotiation and interaction with insures, and claimants, ensuring that company resources are utilized in a cost-effective manner in the process. The adjuster reports to a WC Supervisor.  Responsibilities Thoroughly investigating workers’ compensation claims by contacting injured workers, medical providers, and employer representatives. Determining if claims are valid under applicable workers’ comp statutes. Communicating with medical providers to develop and authorize appropriate treatment plans. Reviewing and analyzing medical bills to confirm charges and treatment are workers’ comp injury-related and...

It’s a great time to join AAA The Auto Club Group!   JOIN THE TEAM COMMITTED TO DRIVING YOUR CAREER FORWARD Job Type: Full time   Exempt/Non Exempt:   Salary Job Description:   ***This position is currently able to work remotely from a home office location for day-to-day operations unless occasional travel for meetings, collaborative activities, or team building activities is specified by leadership. This is subject to change based on amendments and/or modifications to the ACG Flex Work policy. *** APD Claim Representative II (Regional) – The Auto Club Group Reports to: APD Claim Manager I What you will do: (Primary Duties & Responsibilities) The Auto Club Group is seeking an Auto Claim Representative II who works under normal supervision with an intermediate-level approval authority to handle moderately complex claims within Claim Handling Standards in the field or inside units.  Resolve coverage questions, take statements...

The WC 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 position. 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 Senior Claims Specialist handles complex and high-profile Workers' Compensation claims following company standards. This role works closely with case managers and attorneys, manages subrogation, and negotiates settlements. The Senior Claims Specialist ensures the best possible outcome for the claim, meeting customer service expectations, and supporting the goals of the Claims Department and CorVel. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claim, confirms policy coverage and acknowledgement of the claim Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies Establishes reserves and authorizes payments within reserving authority limits Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim Coordinates early return-to-work efforts with the...