Claims Examiner

Davies•Home, AL

14h•Onsite

About The Position

The Claims Examiner will focus on Stop Loss claim reviews for multiple clients. The focus of their daily activities will be claim reviews and reporting their findings to the client while maintaining key performance metrics. The successful candidate will work within the Excess Claims Management unit in our Danvers, MA Office and, ultimately, will be responsible for managing client expectations for claims review. This person will create appropriate reporting documents and correspondence based on review and analysis of data, policies and related information.

Requirements

Experience within insurance, reinsurance, healthcare claims, or a claims administration environment.
Strong analytical skills with the ability to review claims, policies, and supporting documentation accurately.
Excellent attention to detail and a commitment to delivering high-quality work within agreed service levels.
Strong written and verbal communication skills, with experience liaising directly with clients and stakeholders.
Proficiency in Microsoft Office applications, particularly Excel, and experience using claims management systems.

Responsibilities

Accountable for delivering recommendations via client claims systems, standardized reporting, individual claimant worksheets and cumulative bordereaux
Collaboratively working with clients and colleagues providing support in all areas of the review process