Claims Examiner

TPI Global Solutions; United States; Remote; USD 60,000 - 90,000; Full time

Job summary

TPI Global Solutions is seeking an Account Manager to oversee claims management, requiring 3-8 years of experience specifically in Workers Compensation. The role involves assessing claims, determining validity, and preparing detailed reports. This is a 3-month contract with potential for extension or conversion, working remotely in Ohio jurisdiction.

Qualifications

• 3-8 years of experience in Claims or similar organization.
• Ability to work independently while assimilating various technical subjects.

Responsibilities

• Receives claim assignment and confirms policy coverage.
• Investigates, evaluates, negotiates and adjudicates claims.

Skills

Problem Solving

Communication

Analytical Skills

Interpersonal Skills

Education

Bachelor's degree or equivalent experience

Job description

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Account Manager with TPI Global Solutions

Claim Examiner

3-month contract - high possibility of extension or conversion

Remote

Workers Compensation - 3-8 Years of experience - Ohio Jurisdiction Workers Comp Exp.

Receives claim assignment, confirms policy coverage's and directs acknowledgement of claims. - Interprets and makes decisions using independent judgment on moderate difficulty claims and policy coverage's and determines if coverage's apply to claims submitted. - Investigates, evaluates, negotiates and adjudicates first and third party claims to determine validity and verify extent of damage by telephone contact with clients, claimants, witnesses or other parties as required. - Analyzes claims activity and prepares reports for clients/carriers and management. - Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements. - Make settlement decisions promptly and equitably and issues company drafts in payments for claims within authority limits. - Develops subrogation and third party recovery potential and follows reclaim procedures. - Analyzes claims activities and prepares reports for clients, carriers and/or management. Participates in claim reviews.

Ability to work independently while assimilating various technical subjects. - Good verbal or written communication skills. - Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action. - Strong ability to identify, analyze and solve problems. - Effective interpersonal skills to be capable of dealing with external sources and all levels of employees.

Bachelor's degree or equivalent experience required. - Comprehensive claims investigations 3-8 settling experience years experience in Claims or similar organization

-

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Contract

Job function

• Job function

  Research and Other

• Industries

  Insurance

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