10 lead claim examiner i jobs found

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Overview The Workers' Compensation Examiner Lead 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. The Lead Examiner  is often, though not always, assigned to larger or more complex claims than an Adjuster I or II. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of AmTrust and the Claims organization.    This position will sit 4 days hybrid out of our Princeton NJ 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...

Overview The Workers' Compensation Examiner Lead 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. The Lead Examiner  is often, though not always, assigned to larger or more complex claims than an Adjuster I or II. Maintains a solid understanding of AmTrust’s mission, vision, and values. Upholds the standards of AmTrust and the Claims organization.    This position will sit 4 days hybrid out of our Oak Brook 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...

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....

Job Responsibilities and Requirements KEY RESPONSIBILITIES *other duties as assigned*   The Supplemental Health Claims Examiner I evaluates and processes lines coverage handled in the Supplemental Health Claims Department in accordance with applicable law and company guidelines. Claims may include Wellness, Accident, Critical Illness, and Hospital Indemnity benefits.  The goal of the role is to consistently pay the accurate amount for each claim in accordance with the contract. This role also provides customer service that is respectful, prompt, concise, and accurate in an environment with competing demands.     Analysis and Adjudication Reviews and processes Wellness, Accident, Critical Illness, or Hospital Indemnity claim documents and proofs to verify eligibility based on contractual provisions and premium status within company guidelines and applicable law. Authorizes claim payments up to $5,000. Determines proper payee, verifies the accuracy of...

Overview We are seeking experienced professionals to join our Workers’ Compensation team as a Senior Claim Examiner . Both positions play a critical role in managing workers compensation claim files and ensuring compliance with state regulations while delivering exceptional service.   Senior Claim Examiner Manage complex and high-exposure workers’ compensation claims from start to resolution. Investigate claims, determine compensability, set reserves, and negotiate settlements. Serve as a resource for junior examiners and assist with mentoring. Requires 5+ years of workers’ compensation claims experience and strong technical knowledge.   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...

Overview We are seeking experienced professionals to join our Workers’ Compensation team as a Senior Claim Examiner . Both positions play a critical role in managing workers compensation claim files and ensuring compliance with state regulations while delivering exceptional service.   Senior Claim Examiner Manage complex and high-exposure workers’ compensation claims from start to resolution. Investigate claims, determine compensability, set reserves, and negotiate settlements. Serve as a resource for junior examiners and assist with mentoring. Requires 5+ years of workers’ compensation claims experience and strong technical knowledge.   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...

We are adding a Claims Adjudicator to our team! Who We Are: Since 1909, National Guardian Life Insurance Company (NGL) has been one of America’s most successful and highly rated independent life insurance companies. We specialize in a suite of innovative products for life’s journey, giving people the financial stability, careful guidance and peace of mind to lead a life filled with confidence, dignity and grace.   NGL's Core Values – integrity, dependability, collaboration, compassion and growth are a foundation of our company and help to build on the interactions we have with our policyholders, partners, funeral homes and each other. We believe in creating an inclusive, welcoming environment for all where diversity is celebrated, and everyone is encouraged to live their best, most authentic self. We offer  Employee Resource Groups for employees to get involved, learn, network, and offer professional and personal development opportunities. With over...

Job Responsibilities and Requirements Obtains and analyzes information to make claim decisions and payments on LTD, Voluntary disability and Waiver of Premium claims. The goal of the position/role is to consistently render appropriate claim determinations based on a review of all available information and the terms and provisions of the applicable policy.  Reviews and investigates disability claims by using telephone and written contact with the applicable parties, (claimant, employer/supervisor, credit union, treating physician, etc.) to gather pertinent data to analyze the claim. Adjudicates claims accurately and fairly in accordance with the contract, appropriate claim policies and procedures, and state and federal regulations, meeting productivity and quality standards based on product line. Utilizes appropriate medical and risk resources, adhering to referral polices, and transferring claims to the appropriate risk level in a timely manner. Conducts in-depth...

We are adding a Claims Adjudicator to our team! Who We Are: Since 1909, National Guardian Life Insurance Company (NGL) has been one of America’s most successful and highly rated independent life insurance companies. We specialize in a suite of innovative products for life’s journey, giving people the financial stability, careful guidance and peace of mind to lead a life filled with confidence, dignity and grace.   NGL's Core Values – integrity, dependability, collaboration, compassion and growth are a foundation of our company and help to build on the interactions we have with our policyholders, partners, funeral homes and each other. We believe in creating an inclusive, welcoming environment for all where diversity is celebrated, and everyone is encouraged to live their best, most authentic self. We offer  Employee Resource Groups for employees to get involved, learn, network, and offer professional and personal development opportunities. With over...