Claim Examiner/Adjuster at US Tech Solutions, Inc.

Duration: 06 months (Possible extension)

Job

Description:

· Must Have Active New York Adjusters License

Responsibilities:

· Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.

· Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.

· Resolve complex, severe exposure claims, using high service-oriented file handling.

· Pay and process claims within designated authority level.

· Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.

· Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.

· Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.

· Confer with legal counsel on claims requiring litigation.

· Contact or interview claimants, doctors, medical specialists, or employers to get additional information.

· Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis.

Experience:

NA

Skills:

· Licensing requirements vary by state: Active New York state adjuster's license required; multiple state licenses encouraged.

· Proficiency in analytical, document management, and database query software.

· Proficiency in Microsoft Office applications.

· Two to four years of work-related experience.

· Exceptional attention to detail.

· Excellent customer service and communication skills.

· General knowledge of state and national laws and regulations.

· General understanding of medical and legal terms.

· Experience in a claims production environment with set goals and quality scores that must be obtained.

Education:

High school diploma or bachelor’s degree