About this role
Role Overview
- To analyze mid
- and higher-level general liability claims to determine benefits due.
- To ensure ongoing adjudication of claims within company standards and industry best practices.
- To identify subrogation of claims and negotiate settlements.
- Manages mid-level general liability claims by gathering information to determine liability exposure.
- Assigns reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
- Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
- Manages subrogation of claims and negotiates settlements.
- Communicates claim action with claimant and client.
- Ensures claim files are properly documented and claims coding is correct.
- May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
- Maintains professional client relationships.
Requirements
- Bachelor's degree from an accredited college or university preferred.
- 4 years of Liability claims management experience or equivalent combination of education and experience required.
- Jurisdiction: Multi state, mainly FL Licensing: Reciprocal required.
Benefits
- Flexible work schedule.
- Referral incentive program.
- Career development and promotional growth opportunities.
- A diverse and comprehensive benefits offering including medical, dental vision, 401K on day one.