Claims Examiner Jobs

Job Title: Casualty Claims Examiner/Manager Company: Location: Richmond, VA Description: This position contributes to the company's success by reviewing and evaluating accident investigative materials to estimate the monetary value of the Company's casualty exposure (Bodily Injury and Property Damage) for accidents involving our rentals. Determines coverage, assesses liability and damages in accordance with the applicable state laws and evaluates/negotiates to conclusion, including litigation. Handles claims in accordance with best practices methods. The position may be dedicated to a specific geographic region. Essential Duties and Responsibilities: · Establish timely reserves based on the facts developed, establish effective diary dates, review and direct the activities of independent adjusters. · Interview and obtain recorded statements via telephone of renters, claimants, and witnesses, as applicable. · Evaluate reports received covering all aspects of the claim, adjust reserve amounts based on newly developed information, instruct independent adjusters concerning investigative efforts and research and investigate potential primary/secondary insurance coverage as well as contributing insurance policies · Negotiate the settlement of claims and control loss severity. · Ensure appropriate claim file documentation and reporting information secured as a result of claim activity, ensure rationale for settlement/disclaimer that is consistent with Company procedures, reporting standards and guidelines · Determine the extent of damages, coordinate and establish repair/damage estimates, enter into settlement negotiations within assigned authority level. · Ensure timely service levels, evaluations, reporting, and payments. · Manages litigation. · Position will require quality writing skills and significant written reporting. · Occasional travel to trials/mediations/arbitrations may be required. · Assist SIU with investigation of fraudulent activities. Requirements: 3 - 5 years of casualty claims experience 3 - 5 years experience working in a customer facing role 3 - 5 years experience documenting information in a regulated environment Assets: Adjuster's License Litigation experience Mediation experience Clinical medical experience

Job Title: Home Insurance Claims Examiner Company: AppleOne Location: Menlo Park, CA Description: Immediate need for home owners insurance examiner seeking stable company, great benefits and room for advancement. Dependability, key eye for detail, and strong time management will be keys to success in this stable organization. Will be responsible to review claims after they are submitted in order to ensure that proper guidelines have been followed. This person should have at least 5 + years of home owners insurance examiners experience. Direct Hire opportunity with great benefits! Apply for this great position as a home owners insurance examiner today, please call and speak with Norma.df-lj

Job Title: Property Claims Examiner (302514-773) Company: ZC Sterling Location: Dallas, TX Description: 302514-773 Job Description ZC Sterling Corporation ZC Sterling and its subsidiaries have served the mortgage industry for more than 30 years and the homebuilder industry for more than 55 years. ZC Sterling's philosophy of service-driven innovation is what makes us a leading provider of specialty insurance and outsourcing solutions provider for the mortgage, homebuilder and insurance industries. ZC Sterling's industry-recognized serviced are provided by more than 1200 employees from offices across the country in Atlanta, Georgia; Irvine, California; West Hills, California; Raleigh, North Carolina; Jacksonville, Florida; Harlan, Iowa; Lincoln, Nebraska; Dallas, TX. Property Claims Examiner SUMMARY:Responsible for handling of all aspects of a claims file from beginning to conclusion.SPECIFIC DUTIES: Interprets the insurance contract and applies to the exposures presented with each claim. Investigates all issues to determine cause, scope, damages, and subrogation potential. Manages an inventory of claim files to ensure timely resolution of all assigned claims. Maintains files in an organized manner. Documents all activity to support the outcome of the claim file. Evaluates and negotiates the resolution of claims, while mitigating damages, to achieve cost effective claim outcomes. Controls allocated expenses to the claim file. Directs, controls, and manages the work of vendor partners to ensure their work meets our quality expectations. Creates a high level of policyholder satisfaction. Operates in a team environment. Supports other team members to enhance overall team productivity. Leads and participates in committees or special projects. Performs all other duties as assigned. Regular, predictable attendance required. WORKING RELATIONSHIPS:INTERNAL: Claim Sr. Management, Claim Handlers, Claim Support Staff, IT staff and Management, Human Resources, Product Management, Policy Services and others. EXTERNAL: Customers, Customer Representatives, Vendors and Trading Partners REQUIRED KNOWLEDGE AND SKILLS: 4-year college degree, and/or professional insurance designations, and/or relevant long term experience preferred. Minimum of 1-2 years experience handling insurance claims preferred. Ability to work under tight deadlines and handle multiple tasks simultaneously. Strong interpersonal, written and verbal communication skills. Proficiency with MS Office Suite SPECIAL DEMANDS OR WORKING CONDITIONS: Workload is subject to deadlines. Required Experience     At ZC Sterling, our employees are our greatest asset. Like any company or individual, ZC Sterling wants to protect its assets. That’s why we offer a comprehensive and competitive benefit program to our employees.  Our benefits include Medical, Dental, company paid vision (employee coverage), STD, LTD and 2x’s salary life insurance.  We also offer:  Casual Dress, Discount Banking/Credit Union, Service Awards, Team & Individual Recognition Bonuses and Work/Life Balance. ZC Sterling is an equal opportunity employer. It is the policy of ZC Sterling that all employees and applicants for employment will be treated in all respects on the basis of their merit and qualifications and without regard to their race, color, national origin, age, disability, sexual orientation, religion, gender, military status, marital status or ancestry. Job Location Dallas, TX, US. Position Type Full-Time/Regular

Job Title: Casualty Claims Examiner Company: Confidential Location: New York, NY Description: Job DescriptionOur client is a leading Managing General Agency specializing in habitational Real Estate. They are in need of a Casualty Claims Adjuster to work in their downtown NYC location. They are open to a seasoned casualty claims examiner or an energetic, hard working, quick learner who can work in a fast paced environment and looking to start a career in claims adjusting/desk examining. The candidate must either have an adjusters license or be willing to obtain one. An excellent salary and benefits package applies for the right candidate. Job RequirementsNYS Adjusters License or willing to obtain one.Ability to work in a fast paced environmentComputer literateSome College PreferredIf interested in this opportunity send your resume in MS Word format to [Click Here to Email Your Resumé] Att: Richard Davis

Job Title: claims examiner Company: Cognizant Technology Location: Phoenix, AZ Description: We have multiple Healthcare Claims Examiner positions open within our company. All these positions are full-time. Selected candidates must be willing to join at a short notice.  The positions will be based in our Phoenix, AZ data center.  Candidates must be local to the area.  Job Description: Examine and process simple to complex medical claims.  Must meet and exceed Quality and Production standards.   The ideal candidates will possess the following: Insurance Claims/Billing or Healthcare experience.Knowledge of Office PC applications – ability to navigate PC effortlesslyExcellent verbal & written communication skillsAttention to detail, self-starter, self-motivator, positive attitude Benefits include: Medical, Dental & Vision Insurance401k & Employee Stock Purchase Plans2 weeks of vacation and major holidays offTremendous opportunity for growth and advancementA professional, challenging environment as part of a world class talented team  Qualified candidates can email their resumes in MS Word format to Register to View . Please indicate “Claims Examiner” in the subject line.    NOTE: We will only be able to respond to those candidates that most closely meet our criteria. A Snapshot about Us:Cognizant (NASDAQ: CTSH) is a leading provider of IT services. Focused on delivering strategic information technology solutions that address the complex business needs of its clients, Cognizant uses its own on-site/offshore outsourcing model to provide applications management, development, integration, and reengineering; infrastructure management; business process outsourcing; and numerous related services, such as enterprise consulting, technology architecture, program management, and change management. Cognizant's 72,000+ employees globally are committed to partnerships that sustain long-term, proven value for customers by delivering high-quality, cost-effective solutions through its development centers in India and on-site client teams. Cognizant maintains P-CMM and SEI-CMM Level 5 assessments from an independent third-party assessor, was recently named one of Forbes' Best Small Companies in America for the fourth consecutive year, and ranked among the top information technology companies in Business Week's Hot Growth Companies. Cognizant is a member of the NASDAQ-100 Index and S&P 500 Index. We offer a complete Benefits package including Medical and Dental Insurance coverage for self and family, paid vacation, Short and Long term Disability Insurance, ESPP (Employee Stock Purchase Plan), Relocation Assistance, Group Life Insurance, etc. Find additional information about Cognizant at www.cognizant.com.

Job Title: to $20hr/Medical Claims Examiner III Company: AppleOne Location: Anaheim, CA Description: Claims Examiner IIIWhat you will be doing:- Review and process all contracted capitated claims and fee-for-service PCP administration fee for-service claims paid and or denied while achieving and maintaining a 95% accuracy rate. - Review and process claims acknowledgment, payment and denial as set forth by CMS, Healthplans and departmental policy and procedures while achieving and maintaining a 95% timeliness standards.- Achieve and maintain 95% production requirements per claim type utilizing departmental policy and procedures as established per Healthplan and Network. - Recognize inappropriate CPT, ICD-9, HCPCS, and Revenue codes and accurately research member eligibility, duplicate claims submissions, out of network services, out of area services and COB and adjudicateaccording to departmental procedures. - Monitor and update inventory reports in order to track claims in inventory and follow-up on all claims suspended for review purposes or additional information requests until claims are in a final status.What you need to apply:- 4 years of experience prior experience as a Claims Examiner in an IPA, Medical Group or Health Plan.- Familiarity with computerized claims processing/transaction system- Should be familiar with the Microsoft windows operating environment.If you are an experienced Claims Examiner and looking for a position with growth, please apply today!df-lj

Job Title: Sr. Liability Claims Examiner Company: Tower Group Companies Location: Irvine, CA Description: Job Type: Full-Time Location: Irvine, CA Job Description:GENERAL SUMMARY Handles the most complex claims including complex coverage issues, preferably those arising out of a specific program or within specific state jurisdictions. ESSENTIAL RESPONSIBILITIES & DUTIES * Review and analyze coverages that apply to the claim * Prepare draft coverage letters as necessary * Plan and execute investigations of liability and damages on both first and third party claims * Apply facts as determined by investigation to the particular law of the jurisdiction to properly evaluate claim exposures * Establish reserves based on evaluation and adjust reserves as necessary with all new information * Work with defense counsel to establish agreed upon complex litigation plans and budgets on all litigated files * Determine and execute proper disposition plans on all claims, negotiating claims to a conclusion to minimize litigation where appropriate * Control expenses such as independent adjuster and defense costs * Minimizes losses through identification and collection of subrogation and prompt disposal of salvage * Provide excellent customer service to both Partner Agents, insureds and claimants * Develops knowledge of program specific business * Work closely with Corporate Claims in the investigation, analysis and settlement of complex and high exposure claims * Achieve quality initiatives * Assists in the mentoring and training of less experienced staff * Other duties as assigned by Supervisor or Manager DESIRED QUALIFICATIONS Education * Bachelor’s degree preferred * Professional insurance designation desirable Experience * Minimum of 5 years complex casualty or auto claim handling experience is required * Experience handling litigated claims and coverage issues is required * Experience with Commercial and Personal lines policy forms preferred * Inland Marine and/or Property claims experience a plus * Alternative Dispute Resolutions and structured settlements Skills * Licensed as an adjuster or the ability to be licensed in multiple states * In-depth knowledge of the Commercial Auto, General Liability and Homeowners policy and coverage * Ability to analyze contracts and indemnity agreements * Able to analyze coverage issues, as well as prepare Reservation of Rights letters and * Disclaimers * Ability to work in a team environment * Excellent verbal and written skills are necessary * Strong attention to detail * Proficient in the use of Microsoft Office products (i.e. Word, Excel) * Ability to partner with policyholders and defense counsel in litigation Other * Minimal travel required (approximately 5-10%) Physical * Occasional bending, reaching, and light physical effort (under 10 pounds) required. We are an equal opportunity employer dedicated to the professional development and success of its employees. Tower offers a highly competitive compensation package, with comprehensive benefits package.

Job Title: Medical Claims Examiner Company: Pro Search, Inc Location: Portland, ME Description: Medical office in Greater Portland is seeking an experienced Medical Claims Examiner who wants to be part of a growing organization.  This role will be responsible for verifying and editing data for routine and/or complex claims in a timely mannor.  Will also be responsible for scanning and filing claim forms.  Successful candidates will meet the following requirements. 2+ years of claims experience, preferably medical claims ability to accurrately and efficiently process claims at varying levels of complexity excellent data entry skills ability to meet department productivity standards and to maintain confidentiality knowledge of medical terminology and ICD-9, CPT and HCPCS coding preferred strong team player with excellent communication skills Compensation DOE, excellent company benefits package.

Job Title: PHYSICIAN INSURANCE EXAMINER Company: Location: Portland, OR Description: LICENSED PHYSICIANS - INTERNAL MEDICINE / FAMILY PRACTICE (Currently practicing or retired) If you are looking for additional PERMANENT PART-TIME INCOME without the expense of real estate, office equipment, employees and malpractice insurance this could be a great opportunity. Our Business: When an insurance agent has an applicant for life and/or disability insurance, part of the application process is a medical screen. APPS Paramedical is a clearinghouse for this information. As an APPS affiliated physician, with our scheduling department, you will coordinate appointments with the applicant at their home or place of business to perform a medical screen which may include one or more of the following: Medical History Interview Medical history of illnesses, injuries, surgeries and medications including the prescribing Physician with their address and phone number. Comprehensive physical exam ? as specified by the insurance company Vital Measurements ? Height, Weight, Blood Pressure, Pulse Specimen Collection ? Blood (Two-tube straight Vacutainer draw) ? Urine ? Saliva (We provide Lab Kits with everything necessary including shipping Information to forward specimens to our lab.) EKG Tracing ? 12-Lead resting EKG (This is a portable machine. No interpretation is necessary) Up-to-date Communication on all Open Cases Following the Appointment: ? Prepare and ship specimens to designated lab ? Forward completed paperwork as requested Compensation Physicians are paid for each procedure performed and paid twice a month based on work completed. Our Ideal Candidate ? Must have superb phlebotomy skills (Vacutainer draws), be able to record an accurate and legible health history, and perform EKG?s. ? Must be able to travel the I-5 Corridor ? Have a clean, neat and professional presentation. ? Have excellent time management, interpersonal communication and organizational skills. ? Competent at working independently. ? Must have a valid driver?s license, reliable transportation and proof of vehicle liability insurance Who We Are: APPS Paramedical is one of the nations leading providers of mobile insurance exam services with 100 offices across the country. Our Regional Office serves Oregon and Southwest Washington with Physicians and Examiners servicing their local communities. We have a reputation for completing high quality work and taking care of the people who choose to work with us. CONTACT: Anne Hudson ? Human Resource Director PHONE: Register to View E-MAIL: Register to View Mark Meyer ? Regional Director PHONE: Register to View E-MAIL: Register to View

Job Title: Global Claims Examiner Company: Ace USA Location: Philadelphia, PA Description: Global Claims Examiner- Philadelphia, PA ACE USA is the U.S.-based division of the ACE Group of Companies, which provides insurance and reinsurance for a diverse group of clients around the world. Through subsidiaries of the ACE Group of Companies, ACE INA offers a broad array of sophisticated property, casualty, accident and health, and financial products, and risk management services to corporate and consumer clients across the U.S.   ACE USA is dedicated to recruiting and developing talented individuals with the knowledge, ability and desire for success.  With our strong capital base, financial stability, diversified earnings stream and multinational operating platform, we offer an excellent opportunity for your future growth and development.    Key Objectives Summary This position will be a key contributor to the ACE Group Claims management of total cost of claims across the ACE organization.  The successful individual will provide support by promoting Group-wide disciplined management of Indemnity and ALAE dollars, large claim management tracking, management of  key projects and oversight activities. Position has tremendous growth opportunity.    Specific Key Responsibilities:  •           Support the entire Claims Organization in the implementation and on-going management of claim cost-reduction initiatives including the Group Legal and Non-Legal Vendor programs; North America Structured Settlement Program; and North American Subrogation Initiative. •           Assist in coordination and analysis of significant claims with exposures that impact multiple insureds and/or subsidiaries.   •           Provide training to the Claim subsidiaries on a variety of topics including the use of loss reduction tools and claim handling practices. •           Assist in Quality Measurement Reviews/Audits of domestic and international claim teams.   Qualifications •           Quick-thinking, self-starter capable of working independently, and as part of a team, with the ability to meet tight deadlines while maintaining an attention to detail. •           Bachelor’s degree required. Law students and newly admitted lawyers with insurance/claims experience will be strong candidates.  •           Background and skills should include most of the following: •           2-4 years claim handling experience within the Property & Casualty insurance industry; •           Strong leadership, management and interpersonal skills; •           Excellent written communication and oral presentation skills. ACE offers a competitive salary plus cash bonus, equity opportunities and comprehensive benefits package including life, health and dental, vision, a generous retirement savings plan with company match, disability coverage, stock purchase plan, flexible spending accounts, tuition reimbursement, and business casual dress. If you are interested in this role, please send your resume to Kyndra B. Nagy at Register to View . If you’d like additional information about ACE INA, please visit our website at www.acegroup.com