The examiner is responsible for reviewing, investigating, and resolving complex commercial automobile and general liability claims, including those in litigation. They must interpret policy information, manage outside service providers, and establish accurate reserves while maintaining clear communication with all involved parties.
The analyst provides technical and functional support for claims-related applications and RMIS products while serving as a liaison between Claims Operations and IT. They are responsible for analyzing system workflows, troubleshooting user issues, and recommending process improvements to enhance operational efficiency.
The medical case manager coordinates telephonic resources and treatment plans within a workers' compensation environment to facilitate quality care and return-to-work outcomes. They are responsible for assessing medical records, communicating with all involved parties, and monitoring treatment progress to ensure cost-effective and timely recovery.
The role involves managing vendor relationships and performing administrative duties. It focuses on clerical support within a remote operational framework.
Provide telephonic case management within a workers' compensation environment to coordinate cost-effective treatment and facilitate return-to-work placement. Responsibilities include conducting initial assessments, monitoring medical appointments, and negotiating treatment plans with physicians.
Oversee the performance of a case management team and implement best practices to achieve departmental goals. Manage daily operations, human resource functions, and ensure compliance with regulatory requirements and client expectations.
Provide administrative support to case management staff by setting up referrals in the system and routing incoming calls. Coordinate communication between providers, patients, and physicians to ensure accurate patient information and documentation.
Responsible for preparing and maintaining provider contracts and the contracts database system. Ensures all providers maintain active status by completing initial and subsequent credentialing packages in compliance with state regulations.
Responsible for the prompt review of policy information to determine coverage and conducting efficient investigations for Commercial Auto and General Liability claims. The role involves managing litigation, communicating settlement strategies to clients, and providing coverage for permanent examiners during absences.
Responsible for reviewing policy information to determine coverage and conducting efficient investigations for Auto and General Liability claims. This includes managing litigated matters, communicating settlement strategies to clients, and maintaining accurate loss reports and reserves.
The Claims Examiner III Team Leader manages auto liability and PIP/No-Fault claims while providing technical guidance and support to a team of adjusters. They are responsible for maintaining a reduced caseload, ensuring claim quality, and assisting with training and performance management.
The Consultant provides expert safety, risk, and loss control consultation services to clients, focusing on assessing needs, developing tailored prevention programs, and implementing effective risk mitigation strategies across various industries. This role involves onsite and virtual service delivery, staff mentoring, and acting as a subject matter expert to help clients save lives and prevent injuries.
The Consultant provides expert safety, risk, and loss control consultation services to clients, focusing on assessing needs, developing tailored prevention programs, and implementing effective risk mitigation strategies across various industries. This role involves delivering onsite and virtual services, creating action plans, conducting loss control surveys, and ensuring clients enhance their safety culture and reduce workplace hazards.
The Consultant provides expert safety, risk, and loss control consultation services to clients, focusing on assessing needs, developing tailored prevention programs, and implementing effective risk mitigation strategies across various industries. Responsibilities include conducting onsite and virtual safety evaluations, creating action plans, and collaborating with clients to enhance safety culture and ensure regulatory compliance.
The examiner manages all aspects of indemnity claims handling from inception to conclusion, handling a caseload of 150 or fewer workers’ compensation files, including reasonably complex claims. Duties involve investigating claims, determining compensability, administering benefits, managing medical treatment, and setting reserves within guidelines.
