Claims Examiner - 4

Comptech Associates Inc.; Portland (OR); Hybrid; USD 65,000 - 85,000; Full time

Job summary

Comptech Associates Inc. in Portland, OR is seeking an experienced Workers' Compensation Claims Specialist to investigate and resolve claims with diligence and integrity.

You will interview insureds, claimants, witnesses and medical professionals; assess liability, prepare reports, set reserves, and communicate results clearly to teams and claimants while aiming for prompt, fair settlements.

Qualifications

• 2+ years’ experience handling workers’ compensation claims.
• Strong communication and interpersonal skills to interact with claimants, customers, insureds, attorneys.
• Ability to self-motivate and work independently.
• Knowledge of company products, services, coverages and policy limits.

Responsibilities

• Receive assignments and review claim and policy information to support investigations.
• Contact and interview insureds, claimants, witnesses, physicians, attorneys, police to gather claim information.
• Evaluate facts to determine liability and extent of company obligations.
• Prepare investigation reports, settlements, denials, and evaluations of involved parties.
• Set reserves within authority and suggest reserve changes.
• Prepare and submit to Team Leader unusual exposures.
• Settle claims promptly and equitably.
• Obtain releases, proofs of loss, and drafts for payments.
• Inform claimants of denial when applicable.

Skills

Communication skills

Interpersonal skills

Independent worker

Self-motivation

Claims knowledge

Education

Bachelor's degree

WC Insurance experience

Job description

Location: 12909 SW 68th Parkway Ste. 450, Portland, OR USA 97223

Duration: 6+ Months (CTH)

Job Schedule: Full-time in office, then hybrid 3 days in office, 2 days work from home.

In office Tues-Thurs, WFH Monday/Friday

Work schedule: 8:00am-4:30pm PCT--1/2 hour lunch break

Interview process: Possible virtual screening call, followed by on site interview

Major Duties & Responsibilities:

Duties include but are not limited to:

• Under limited supervision, receives assignments and reviews claim and policy information to provide background for investigation and may determine the extent of the policy’s obligation to the insured depending on the line of business.
• Contacts, interviews and obtains statements from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
• Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extend of the company’s obligation to the insured under the policy contract.
• Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.
• Sets reserves within authority limits and recommends reserve changes to Team Leader.
• Prepares and submits to Team Leader unusual or possible undesirable exposures.
• Settles claims promptly and equitably.
• Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.
• Informs claimants, insureds/customers or attorney of denial of claim when applicable.

Desired Qualifications:

• 2+ or more years’ experience handling workers’ compensation claims.
• Strong communication and interpersonal skills to effectively interact with claimants, customers, insureds, brokers, attorneys, etc., in a positive manner regarding losses.
• Ability to self-motivate and work independently.
• Knowledge of company products, services, coverages, and policy limits, along with awareness of the company’s claims best practices.

Education

Bachelor's degree or WC Insurance experience