Claims Examiner - 4

Comptech Associates; United States; Hybrid; USD 52,000 - 76,000; Full time

Benefits offered by this job

Hybrid work model

Job summary

Comptech Associates in Portland, OR is seeking a Claims Examiner for a 6-month contract. The role starts in-office as full-time, then switches to a hybrid schedule with three days in the office and two days work from home.

Duties include reviewing claims, interviewing insureds or witnesses, evaluating liability, and preparing investigations and settlements under policy terms. The position requires 2+ years of workers’ compensation claims experience, strong communication, independence, and

Qualifications

• 2+ years' experience handling workers' compensation claims.
• Strong communication and interpersonal skills with claimants and colleagues.
• Ability to self-motivate and work independently.
• Knowledge of company products, services, and claims practices.

Responsibilities

• Review claims to determine liability and reserve needs.
• Interview insureds, claimants, and witnesses to gather facts.
• Evaluate evidence to assess scope of obligation.
• Prepare reports on investigations, settlements, and denials.
• Notify claimants of decisions and arrange payments as applicable.

Skills

Workers' comp claims

Communication

Interpersonal skills

Independence

Company knowledge

Education

Bachelor's degree or WC Insurance experience

Job description

**Job Title:**Claims Examiner - 4

**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