Claim Examiner

Immediate need for a talented Claim Examiner. This is a 06+ Months contract opportunity with long-term potential and is located in Garden City,NY(Remote). Please review the job description below and contact me ASAP if you are interested.
Job ID: 22-63693

Pay Range: $18-$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 Responsibilities:

• 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 the 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.

Key Requirements and Technology Experience: 

• Adjuster license in New York State is Required
• Claims processing experience required.
• Adjuster license WA is a plus. (Nice to Have)
• Any Insurance will work, Good to have - Auto Insurance, Homeowner Insurance or catastrophic insurance.
• Travel claims is definitely a plus.
• 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. 
• General knowledge of state and national laws and regulations.
• General understanding of medical and legal terms.

Our client is a leading Insurance organization and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply today for immediate consideration.

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.