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Claims Examiner - Workers Compensation

Remote · Brazil Full-time

Job Description:

  • Manages mid-level water damage claims by gathering information to determine liability exposure; assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
  • Assesses liability and resolves claims within evaluation.
  • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
  • Manages subrogation of claims and negotiates settlements.
  • Communicates claim action with claimant and client.
  • Ensures claim files are properly documented and claims coding is correct.
  • May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
  • Maintains professional client relationships.
  • Performs other duties as assigned.
  • Supports the organization's quality program(s).

Requirements:

  • 4 years of Liability claims management experience or equivalent combination of education and experience required.
  • Bachelor's degree from an accredited college or university preferred.

Benefits:

  • Flexible work schedule.
  • Referral incentive program.
  • Career development and promotional growth opportunities.
  • A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.

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