Job description
Immediate need for a talented
Claim Examiner. This is a
6+ Months contract opportunity with long-term potential and is located in
Garden City,NY. Please review the job description below and contact me ASAP if you are interested.
Job ID: 22-63693
Pay Range: $15-$20/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Requirements and Technology Experience:
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
Job ID: 22-63693
Pay Range: $15-$20/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
Key Requirements and Technology Experience:
- 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. Qualifications/Education:
- Licensing requirements vary by state.
- 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. Desired Qualities:
- General knowledge of state and national laws and regulations.
- General understanding of medical and legal terms.
Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
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