Top insurance firm seeking a highly organized and detail-oriented Claims Examiner, Sr. Claims Examiner and Regional Claims Manager to join their team. You will play a crucial role in our organization's insurance operations. You will be responsible for reviewing and processing insurance claims, ensuring they comply with company policies, regulatory requirements, and industry standards. Your expertise will help ensure that claims are accurately and efficiently assessed, making it possible for our clients to receive the compensation they are entitled to.
Location: Connecticut, USA
- GL or Bodily Auto insurance experience
- Adjuster's License
- Bachelor's degree in a related field (business, finance, or insurance) or equivalent work experience.
- Knowledge of insurance policies, regulations, and industry standards.
- Strong analytical and problem-solving skills.
- Exceptional attention to detail and the ability to work with a high degree of accuracy.
- Excellent communication and interpersonal skills.
- Proficiency in using computer software and database systems for claims processing.
- Ability to work efficiently in a team and handle a high volume of claims.
- Previous experience in claims examination or a related field is a plus.
- Professional certifications in insurance or claims examination are advantageous.
Claim Verification: Review and analyze insurance claims for accuracy, completeness, and compliance with policy terms, conditions, and legal requirements.
Documentation Review: Carefully examine claim documentation, including forms, statements, medical records, and other relevant information, to determine the validity and authenticity of the claim.
Leadership: Responsibility for the management, results and outcomes of all assigned cases within the claims program.
Communication: Maintain effective communication with policyholders, claimants, and other stakeholders to provide updates on claim status, request additional information, and answer inquiries.
Claim Resolution: Collaborate with legal teams and external specialists to resolve complex or disputed claims, ensuring fair and timely settlements