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14400 Arch Insurance Group Inc.
Claims Examiner, DRC
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Based on Pennsylvania data
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What they do
A Claims Examiner evaluates insurance claims in accordance with applicable contracts and government regulations within their insurance type. Determines member eligibility and financial responsibility of the insurance company.
$81,299 / year median in Pennsylvania
+2% projected growth
Job Description
With a company culture rooted in collaboration, expertise and innovation, we aim to promote progress and inspire our clients, employees, investors and communities to achieve their greatest potential. Our work is the catalyst that helps others achieve their goals. In short, We Enable Possibility℠. Position Summary The Claims Division is seeking a team member to join the Shared Services Team as a Claims Examiner. Responsibilities include investigating, evaluating and resolving various types of commercial first and third party low complexity claims. This requires accurate and thorough documentation, as well as completion of resolution action plans based upon the applicable law, coverage and supporting evidence. Responsibilities Provide and maintain exceptional customer service and ongoing communication to the appropriate stakeholders through the life of the claim including prompt contact and follow up to complete timely and accurate investigation, damage evaluation and claim resolution in accordance with regulatory, company standards, and authority level Conduct thorough investigation of coverage, liability and damages; must document facts and maintain evidence to support claim resolution Review and analyze supporting damage documentation Comply and stay abreast of all statutory and regulatory requirements in all applicable jurisdictions Establish appropriate loss and expense reserves with documented rationale Demonstrate technical efficiency through timely and consistent execution of best claim handling practices and guidelines Experience & Qualifications Hands on experience and strong aptitude with Outlook, Microsoft Excel, PowerPoint and Work Knowledge of ImageRight preferred Exceptional communication (written and verbal), influencing, evaluation, listening, and interpersonal skills to effectively develop productive working relationships with internal/external peers and other professionals across organizational lines Ability to take part in active strategic discussions and leverage technical knowledge to make cost-effective decisions Strong time management and organizational skills; ability to adhere to both internal and external regulatory timelines Ability to work well independently and in a team environment Texas Claim Adjuster license preferred, but not required for posting. Upon employment candidate would be required to obtain Texas Claim Adjuster license within six months of hire date. Education Bachelors degree preferred 3-5 years' experience handling the process of commercial insurance claims #LI-SW1 #