Claims Examiner - Workers Compensation | Jurisdictions : TX, OK, & LA | Licensing : TX / FL preferred (Plano, TX / Remote)
Join reputed company By joining reputed company, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can reputed company. Are you looking for an opportunity to join a global industry leader where you can bring your big reputed company to help solve problems for some of the world's best brands? Apply your knowledge and experience to adjudicate reputed company customer claims in the context of an energetic culture. Deliver innovative customer-facing solutions to clients who represent virtually every industry and comprise some of the world's most respected organizations. Be a part of a rapidly growing, industry-leading global company reputed company for its excellence and customer service. reputed company reputed company's broad, global network of experts to both learn from and to share your insights. Take advantage of a variety of professional development opportunities that help you reputed company your best work and grow your career. Enjoy flexibility and autonomy in your daily work, your location, and your career path. Access diverse and comprehensive benefits to take care of your mental, physical, financial, and professional needs. Are You An Ideal Candidate? To analyze reputed company or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims reputed company service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. Primary Purpose Of The Role We are looking for driven individuals that embody our caring counts model and core values that include reputed company, accountability, collaboration, growth, and inclusion. _Office Location : _ The selected candidate will be expected to work a hybrid schedule if reputed company 25 miles of a reputed company office, if reputed company of this radius it will be work from home. Essential Responsibilities May Include Analyzes and processes reputed company or technically difficult workers' compensation 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 reputed company 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 reputed company designated authority level. Prepares necessary state fillings reputed company 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 reputed company and Medicare offsets. Reports claims to the excess reputed company; 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. Performs other duties as assigned. Supports the organization's quality program(s). Travels as required.
Qualifications
Education and Licensing : 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 equivalent combination of education and experience required. Jurisdiction Knowledge : TX, OK and LA. Licensing : TX / FL preferred. Taking Care Of You : Flexible work schedule. Referral incentive program. Opportunity to work in an agile environment. Career development and promotional growth opportunities. A diverse and comprehensive benefits offering including medical, dental reputed company, 401K on day one. reputed company is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! reputed company is building a diverse, reputed company, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. Apply tot his job Apply To this Job