Senior Medical Claims Processor - Davenport, IA, United States - Sentry

Description

Conducts moderate to complex subrogation investigations, evaluations, and communications to determine liability and recovery potential when third-party responsibility has been identified.

Handles and/or assigns collection efforts to outside vendors such as attorney or collection agencies as appropriate. Ensures claim files are documented with all pertinent information.

Utilizes business acumen and experience to consult and advise on subrogation practices and cases, including claims requiring litigation and/or expertise in specified jurisdictional areas.

As a Subrogation Claims Representative Sr, you'll provide prompt subrogation investigation, evaluation, and communication to determine liability and recovery potential when third-party responsibility has been identified.

Investigate moderate to complex property claims.

Verify the nature and extent of the loss, directs the preservation of evidence and identify resources for specific activities to properly investigate claims.

Provides pertinent background information to legal counsel and guides counsel in reaching settlement in litigation and/or mediation.

Summarize findings for high severity claims by highlighting key issues and conversations with experts, as well as presenting cases to senior team members and management for technical feedback.

Negotiates and settles subrogation claim which may involve coordinating arbitration filings on claims involving unresolved damages and/or liability.

Bachelor's Degree or equivalent work experience
~5+ years of related work experience
~ Thorough knowledge of insurance policies and coverage, claim payment procedures, and familiarity with medical and legal terminology
~ Previous claims experience and insurance coursework is beneficial
~ Possess analytical abilities to review, exercise judgement, and evaluate claims to make sound decisions
~ Able to review and interpret complex and detailed documents such as contracts, medical reports, and insurance regulations.

Monday and Friday work from home if you choose to, Tuesday through Thursday you'll work in office.
~ As a Sentry associate, you will have an in-office workspace and materials for your home office. In addition to the laptop, you will receive prior to your start, Sentry will provide equipment for your home office.
~ Meal Subsidy available for associates who report to an office.
~401(K) plan with a dollar for dollar match on your first eight percent , plus immediate vesting to help strengthen your financial future.
~ Continue your education and career development through Sentry University (SentryU) and utilize our Tuition Reimbursement program
~ Generous Paid-Time Off plan for you to enjoy time out of the office as well as Volunteer-Time off
~ Group Medical, Dental, Vision, Life insurance, Parental leave, and our Health and Wellness benefits to encourage a healthy lifestyle.
~ Well-being and Employee Assistance programs
~ Sentry Foundation gift matching program to encourage charitable giving.

We got our start in 1904 and have been helping businesses succeed and protect their futures ever since.

Because of the trust placed in us, we're one of the largest and financially strongest mutual insurance companies in the United States.

Our headquarters is in Stevens Point, Wisconsin, with offices located throughout the United States.

From sales to claims, and information technology to marketing, we enjoy a rewarding and challenging work environment with opportunities for ongoing professional development and growth.

Talent Acquisition Specialist

It is our policy that there be no discrimination in employment based on race, color, national origin, religion, sex, disability, age, marital status, or sexual orientation.