Role OverviewAs a Claims Specialist, you will investigate, evaluate, and resolve assigned claims of a more complex nature to achieve appropriate outcomes. You will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines.
What You Will Do
Investigate assigned claims, determine coverage and compensability, and negotiate claims settlements. You will also work collaboratively with PMA nurse professionals to develop and execute return to work strategies.
Why It Might Be a Fit
This role requires a strong analytical mind, excellent communication skills, and the ability to work independently. You will also need to demonstrate technical proficiency and a commitment to Company's Code of Business Conduct and Ethics.
Requirements
- Bachelor's degree and/or four or more years of equivalent work experience in an insurance related industry
- TX experience required
- Associate in Claims (AIC) Designation or similar professional designation desired
- License required or ability to obtain license within 90 days of employment in mandated states
- Familiarity with medical terminology and/or Workers' Compensation
- Working knowledge of Workers Compensation regulations, preferably jurisdiction-specific
- Strong organizational skills
- Proven critical thinking skills
- Strong verbal, written communication skills and customer service skills
- Computer literacy, including working knowledge of MS Office Product Suite
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