Claims Examiner I

Overview Nakupuna Consulting is seeking a detail-oriented Claims Examiner I to support a federal claims management program by conducting claims intake, investigation, research, documentation, and case administration activities. The ideal candidate possesses strong customer service skills, excellent attention to detail, and the ability to manage multiple cases while maintaining accuracy and compliance with established procedures. Experience in insurance, claims processing, legal support, or quality assurance environments is highly desirable. Responsibilities Conduct initial intake and review of affirmative claims cases and related documentation. Request and obtain police reports, accident reports, medical records, insurance information, and other supporting documentation. Identify potential insurance carriers and gather information necessary to support claim development. Communicate professionally with claimants, insurance representatives, medical providers, attorneys, and government personnel. Perform basic legal and insurance research utilizing available resources such as LexisNexis, Westlaw, and public databases. Research state insurance limits, liability standards, and applicable tort law under the direction of senior claims personnel or attorneys. Draft initial Notices of Claim, standard demand letters, and routine correspondence for supervisory review. Maintain accurate electronic case files within the ACMP or similar claims management systems. Enter and validate case information, track deadlines, and ensure required actions are completed within established timeframes. Review claims files for completeness, accuracy, and compliance with established procedures. Assist with quality assurance reviews, reporting requirements, and process improvement initiatives. Support claims adjudication activities under the direct supervision of senior claims personnel and attorneys. Skills / Qualifications Excellent written and verbal communication skills. Strong customer service and interpersonal communication skills. Strong organizational skills and attention to detail. Ability to manage multiple assignments and deadlines simultaneously. Proficiency with Microsoft Office Suite (Word, Excel, Outlook, and Teams). Ability to conduct research, gather information, and document findings accurately. Ability to work independently and as part of a team. Experience working with insurance companies, claims organizations, or legal support environments preferred. Quality Assurance (QA) or Quality Control (QC) experience preferred. Strong ability to quickly learn new technologies, tools, and processes. Education / Experience Associate's Degree or Bachelor's Degree preferred. Minimum of 1-3 years of professional experience in claims processing, insurance operations, legal support, customer service, case management, or related fields. Experience supporting claims investigations, insurance administration, legal research, or case management activities preferred. Clearance Requirements This position requires the ability to obtain and maintain a Public Trust security clearance. Work Location Charleston, SC preferred. Physical Requirements Ability to perform repetitive motions with the hands, wrists, and fingers. Ability to engage in and follow audible communications in emergency situations. Ability to sit for prolonged periods at a desk and work on a computer. Compensation Projected compensation range: $65,000.00 to $85,000.00 (annualized USD). #J-18808-Ljbffr