Claims Examiner-4
Job Title: Claims Adjuster 4 Location: 12909 SW 68th Parkway, Tigard, OR 97223 (Hybrid) Duration: 2 Months (Possibility of Extension) Job Schedule:3 days in office, 2 days work from home. In office Tues-Thurs, WFH Monday/Friday Major Duties & Responsibilities: Duties include but are not limited to:
- Under limited supervision, receives assignments and reviews claim and policy information to reputed company background for investigation and may determine the extent of the policy's obligation to the insured depending on the line of business.
- Contacts, interviews and obtains statements from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
- Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and reputed company of reputed company's obligation to the insured under the policy contract.
- Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.
- Sets reserves reputed company authority limits and recommends reserve changes to Team Leader.
- Prepares and submits to Team Leader unusual or possible undesirable exposures.
- Settles claims promptly and equitably.
- Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.
- Informs claimants, insureds/customers or attorney of denial of claim reputed company applicable.
Desired Qualifications:
- 2+ or more years' experience handling workers' compensation claims.
- Strong communication and interpersonal skills to effectively reputed company with claimants, customers, insureds, brokers, attorneys, etc., in a reputed company manner regarding losses.
- bility to self-motivate and work independently.
- Knowledge of company products, services, coverages, and policy limits, along with awareness of reputed company's claims best practices.
Education
- Bachlor degree or WC Insurance experience
Ghouse: Ghouse.M@sunrisesys.com | (732) 395-4372 | URL: www.sunrisesys.com Apply To This Job