Claims Examiner Position Available In Duval, Florida

Claims Examiner
Education, Human Resources, Training
$ 50 / Hour
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Jacksonville, Floridapass_calibration
Remote
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Adecco is assisting one of their top clients with their search to fill a Claims Examiner!

Pay:

$50/hr

Location:

Remote

Shift:

Mon – Fri, 8a to 4:30p

Job Description:

PRIMARY PURPOSE

To analyzeplex or technically difficult workers’pensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
Responsibilities for this Claims Examiner include but are not limited to:

• Analyzes and processesplex or technically difficult workers’pensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
• Prepares necessary state fillings within statutory limits.
• Manages the litigation process; ensures timely and cost effective claims resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
• Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
• s claims to the excess carrier; responds to requests of directions in a professional and timely manner.
• Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.
  Experience required for this Claims Examiner person position include:
• Bachelor’s degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
• Experience Five (5) years of claims management experience or equivalentbination of education and experience required.
• Skills & Knowledge
• Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and
• Medicare application procedures as applicable to line-of-business.
• Excellent oral and writtenmunication, including presentation skills
• PC literate, including Microsoft Office products
• Analytical and interpretive skills
• Stronganizational skills
• Good interpersonal skills
• Excellent negotiation skills
• Ability to work in a team environment
• Ability to meet or exceed Service Expectations
  As a reminder, this role is being recruited for by one of our National Recruitment Teams and not your local Branch.

In order to be considered, please follow the steps included upon your application.

Pay Details:

$50.00 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program,muter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay w applicable.
Equal Opportunity Employer/Veterans/Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to adecco/en-us/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
The California Fair Chance Act
Los Angeles City Fair Chance Ordinance
Los Angeles County Fair Chance Ordinance for Employers
San Francisco Fair Chance Ordinance

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