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UI Overpayments Claims Examiner
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Texas Workforce Commission Austin, United StatesWHO WE ARE: · Texas Workforce Commission connects people with careers across the state. While we are based in downtown Austin, on the north lawn of the Texas State Capitol, we have offices statewide and many of our positions are suitable for teleworking. We're a Family Friendly ...
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King's Insurance Staffing Austin, United StatesOur client is seeking to add a Senior Workers' Compensation Claims Examiner to their California operations. This role will consist of handling moderate to complex Workers' Compensation Lost Time claims throughout the state of California from inception to close. Qualified candidat ...
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STATE OFFICE OF RISK MANAGEMENT Austin, United StatesSORM | Claims Adjuster-Senior Claims Adjuster | Organization · :STATE OFFICE OF RISK MANAGEMENT Primary Location · :Texas-Austin Work Locations · :Office of Risk Management300 W. 15Th St6Th FloorAustin78701 Job · :Business and Financial Operations Employee Status · ...
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King's Insurance Staffing Austin, United StatesOur client is seeking to add a Senior Workers' Compensation Claims Examiner to their New Mexico operations. This role will consist of handling moderate to complex Workers' Compensation Lost Time claims throughout the state of New Mexico from inception to close. Qualified candidat ...
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Contract Specialist III
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Texas Department of Aging & Disability Services Austin, United StatesJob Description: · The Texas Health and Human Services Commission (HHSC) Medicaid CHIP Services (MCS) department seeks a highly qualified candidate to fill the position of Contract Specialist III. MCS is driven by its mission to deliver quality, cost-effective services to Texans. ...
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DPS - IOD - HR ADA Compliance Specialist - 1733
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TEXAS DEPARTMENT OF PUBLIC SAFETY Austin, United StatesGENERAL DESCRIPTION · : Perform highly advanced (senior level) fiscal and administrative work serving as an executive member of the Finance division with responsibilities to assist with financial affairs for all financial programs, agency payroll, accounts payable and travel paya ...
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State Office of Risk Management Austin, United StatesPlease paste the following URL into a browser to view the entire job posting in the CAPPS Career Section: You may apply to the job directly through the CAPPS Career Section. It is not necessary to apply both through Work In Texas and CAPPS Career Section · GENERALDESCRIPTION Th ...
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Hippo Insurance Austin, United StatesRole: Compliance and Customer Resolution Specialist · Location: Austin, TX / Dallas, TX / Bedminster, NJ (Hybrid) · Reports to: Director, Insurance Operations · About Hippo: · Our mission is to deliver intuitive and proactive protection for homeowners, combining the power of tech ...
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Compliance and Customer Resolution Specialist
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Contract Specialist III
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Veterans Affairs, Veterans Health Administration Austin, United StatesSummary The Central Texas VA Health Care System is seeking a full-time Radiologist (Breast Mamogrammy) to perform a wide variety of diagnostic imaging examinations, ultrasound of breasts and biopsies, MRI's and responsible for monitoring the quality of diagnostic interpretations. ...
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Pediatrician (Part-Time, Saturdays)
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SORM | Accountant - Senior Accountant |
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Accountant
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Deputy Assistant Secretary for Finance Austin, United StatesSummary The position is in the Operational Accounting Service (OAS) at the Financial Service Center (FSC) located in Austin, Texas. OAS is responsible for station-level accounting functions for 25 or more stations with multiple organizations. The purpose of this position is to pe ...
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Department of Veterans Affairs Austin, United StatesSummary · The Central Texas VA Health Care System is seeking a full-time Radiologist (Breast Mamogrammy) to perform a wide variety of diagnostic imaging examinations, ultrasound of breasts and biopsies, MRI's and responsible for monitoring the quality of diagnostic interpretation ...
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Revenue Cycle Trainer
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Claims Examiner or Associate Claims Examiner - Austin, United States - USLI
Description
The ideal claims team member will be an analytical and creative problem solver with the ability to hone in on key issues for coverage, liability and damage evaluation. Our claim examiners are assertive decision makers with a strong desire to persuade through negotiation and conflict management. The claims team offers ongoing challenges, even for the most experienced professional, as every claim is unique, providing new opportunities to learn and grow. We welcome our ongoing interaction with underwriting, compliance and actuarial to keep our products healthy.
Essential Functions:
Examiners are responsible forconfirming coverage by reviewing the first notice of loss and policy information. Examiners prepare coverage position letters such as disclaimers and reservation of rights. Once coverage is confirmed, the examiner conducts a thorough and focused investigation of the claim to assess liability and damages. Examiners will retain independent adjusters and provide direction, as appropriate, and will be accountable for all aspects of the investigation including witness interviews/statements, scene inspections, securing documents, videos and other evidence pertinent to the claim evaluation. Examiners must understand and apply statutory and case law to assess liability exposure. Examiners should identify joint tortfeasors and ensure all parties pay their fair share. Examiners are responsible for maintaining adequate reserves as the claim develops to properly reflect ultimate exposure based upon liability and damage evaluation. Examiners are responsible for proactive file management toward final disposition via an effective diary, directly negotiating claims with a claimant or claimant attorney, overseeing defense counsel to ensure effective litigation management with established guidelines and reviewing/approving settlement agreements. Examiners must maintain substantive file notes that document all relevant claim activity. Examiners are responsible for preparing comprehensive and concise reserve authority requests, reinsurance reports, serious loss reports, coverage position letters as well as reports to underwriting and other departments.
Other Duties and Responsibilities:
In addition to the essential functions, an examiner is expected to support customer service by responding the same day to phone and email both internally and externally and adhere to established claim service promises. The position may entail completion of special projects. There is an expectation for enrollment in continuing education to maintain state licenses and to support both professional and personal development as outlined in the annual Individual Development Plan. Occasional travel required attendance at mediation.
Specific Skills:
Strong oral and written communication skills, insightful analytical skills, effective negotiation skills, strong organizational and time management skills, technical knowledge of insurance coverage, negligence law and claim evaluation.
Minimum Job Requirements:
We are seeking 2+ years (Associate Claim Examiner) or 7+ years (Claim Examiner) of relevant experience handling general liability/casualty matters including prior examiner, adjuster, paralegal, attorney/lawyer and/or other transferable experience. Liability experience, multi-jurisdictional knowledge, advanced degrees and/or JD are a plus.
At USLI, our goal is to strengthen our community and culture by representing all races, genders, religions and sexual orientations. We continue to move conversations about diversity, equity and inclusion forward to ensure every community member has a sense of belonging, a voice and a seat at the table.
USLI provides full-time community members with a comprehensive benefits package, access to wellness programs, continuing education resources, and multiple opportunities to get involved with charitable organizations.
