Adecco US, Inc.
Claims Examiner - GL PL (1464228)
Adecco US, Inc., Jacksonville, Florida, United States, 32290
Adecco is assisting a local client recruiting for
Claims Examiner
opportunities
Remote . This is an excellent opportunity to join a winning culture and get your foot in the door with a company that acts as a claims administrator or claims adjuster. If
Claims Examiner
sounds like something you would be interested in, and you meet the qualifications listed below, apply now! Responsibilities for
Claims Examiner
include but are not limited to:
PRIMARY PURPOSE To analyze complex or technically difficult general liability 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.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Analyzes and processes complex or technically difficult general liability 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.
Assesses liability and resolves claims within evaluation.
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 claims within designated authority level.
Prepares necessary state filings 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.
Reports claim 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.
Additional Functions and Responsibilities
Performs other duties as assigned.
Supports the organization's quality program(s).
Travel as required.
Qualification
Education & 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.
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 written communication, including presentation skills.
PC literate, including Microsoft Office products.
Analytical and interpretive skills.
Strong organizational skills.
Good interpersonal skills.
Excellent negotiation skills.
Ability to work in a team environment.
Ability to meet or exceed Service Expectations.
Work Environment When applicable and appropriate, consideration will be given to reasonable accommodation.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
Physical: Computer keyboarding, travel as required.
Auditory/Visual: Hearing, vision and talking.
NOTE Credit security clearance, confirmed via a background credit check, is required for this position.
Manager’s Note Claims Examiner General Liability Professional Liability
Work location: Remote across US.
FL (or any other reciprocal state) and/or NY licenses preferred.
Active licenses are mandatory.
Product liability is a but not a requirement.
Years of experience: 3-5 of relevant experience.
Pay: $31/hr.
Shift: 8 AM - 4:30 PM M-F.
Dedicated Onboarding Specialist & Recruiter Access to Adecco’s Aspire Academy with thousands of free upskilling courses.
This Claims Examiner is being recruited for by one of our Centralized Delivery Team and not your local Branch. For instant consideration for this Claims Examiner position and other opportunities with Adecco, apply today!
Pay Details $31.00 per hour.
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter 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 where applicable.
Equal Opportunity Employer/Veterans/Disabled.
Military connected talent encouraged to apply.
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://uat.adecco.com/en-us/candidate-privacy.
The California Fair Chance Act
Los Angeles City Fair Chance Ordinance
Los Angeles County Fair Chance Ordinance for Employers
San Francisco Fair Chance Ordinance
Massachusetts Candidates Only It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
#J-18808-Ljbffr
Claims Examiner
opportunities
Remote . This is an excellent opportunity to join a winning culture and get your foot in the door with a company that acts as a claims administrator or claims adjuster. If
Claims Examiner
sounds like something you would be interested in, and you meet the qualifications listed below, apply now! Responsibilities for
Claims Examiner
include but are not limited to:
PRIMARY PURPOSE To analyze complex or technically difficult general liability 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.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES
Analyzes and processes complex or technically difficult general liability 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.
Assesses liability and resolves claims within evaluation.
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 claims within designated authority level.
Prepares necessary state filings 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.
Reports claim 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.
Additional Functions and Responsibilities
Performs other duties as assigned.
Supports the organization's quality program(s).
Travel as required.
Qualification
Education & 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.
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 written communication, including presentation skills.
PC literate, including Microsoft Office products.
Analytical and interpretive skills.
Strong organizational skills.
Good interpersonal skills.
Excellent negotiation skills.
Ability to work in a team environment.
Ability to meet or exceed Service Expectations.
Work Environment When applicable and appropriate, consideration will be given to reasonable accommodation.
Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
Physical: Computer keyboarding, travel as required.
Auditory/Visual: Hearing, vision and talking.
NOTE Credit security clearance, confirmed via a background credit check, is required for this position.
Manager’s Note Claims Examiner General Liability Professional Liability
Work location: Remote across US.
FL (or any other reciprocal state) and/or NY licenses preferred.
Active licenses are mandatory.
Product liability is a but not a requirement.
Years of experience: 3-5 of relevant experience.
Pay: $31/hr.
Shift: 8 AM - 4:30 PM M-F.
Dedicated Onboarding Specialist & Recruiter Access to Adecco’s Aspire Academy with thousands of free upskilling courses.
This Claims Examiner is being recruited for by one of our Centralized Delivery Team and not your local Branch. For instant consideration for this Claims Examiner position and other opportunities with Adecco, apply today!
Pay Details $31.00 per hour.
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter 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 where applicable.
Equal Opportunity Employer/Veterans/Disabled.
Military connected talent encouraged to apply.
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://uat.adecco.com/en-us/candidate-privacy.
The California Fair Chance Act
Los Angeles City Fair Chance Ordinance
Los Angeles County Fair Chance Ordinance for Employers
San Francisco Fair Chance Ordinance
Massachusetts Candidates Only It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.
#J-18808-Ljbffr