Claims Examiner

Claims Examiner

Our client, a Global Insurance company, is looking for a Claims Examiner for their Cheektowaga, NY location. Responsibilities include investigating and settling claims promptly and equitably within established best practices guidelines. The role involves receiving new assignments, reviewing claim and policy information, contacting and interviewing various parties to secure necessary claim information, arranging for surveys and experts where appropriate, evaluating facts to determine liability and company obligations, preparing reports on investigations and settlements, setting reserves and recommending reserve changes, reviewing progress and status of claims, managing litigation files, assisting in developing methods for handling claims, settling claims promptly and equitably, obtaining releases and proofs of loss, informing claimants of claim denials, assisting in preparing cases for trial, continuing efforts to settle claims before trial, referring claims to subrogation as appropriate, participating in claim file reviews and audits, administering benefits timely and appropriately, maintaining control of claim's resolution process, establishing and maintaining strong customer relations, maintaining system logs, investigating compensability and benefit entitlement, reviewing and approving medical bill payments, managing vocational rehabilitation, and reporting directly to a Claims Team Leader or other member of claims management.

Requirements include 3-5 years experience handling higher level Workers' Compensation claims, basic knowledge of claims handling and familiarity with claims terminologies, effective negotiation skills, strong communication and interpersonal skills, ability to self motivate and work independently, knowledge of client products, services, coverages and policy limits, awareness of claims best practices, knowledge of applicable state and local laws, state adjusters licensing a plus or will require future licensing, familiarity in computer systems, and 40 words per minute typing skills.

Why Should You Apply? Health Benefits, Referral Program, Excellent growth and advancement opportunities.