IL
Claims Adjuster – Liability
ICONMA, LLC
🇺🇸 United States
Hybrid
Mid level
2 days ago
$26.25 – $31.25 / hour
2 days ago
Responsibilities:
- 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; and 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.
- Assesses liability and resolves claims within evaluation.
- 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.
- Performs other duties as assigned.
- Supports the organization's quality program(s).
Requirements:
- We’d prefer candidates who have supported retail environments
- Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
- Excellent oral and written communication, including presentation skills
- PC literate, including Microsoft Office products
- Analytical and interpretive skills
- Strong organizational skills
- Good interpersonal skills
- Excellent negotiation skills
- Ability to work in a team environment
- Ability to meet or exceed Service Expectations
- Bachelor's degree from an accredited college or university preferred.
- Four (4) years of claims management experience or equivalent combination of education and experience required.
Why Should You Apply?
- Health Benefits
- Referral Program
- Excellent growth and advancement opportunities
Claims Adjuster – Liability · ICONMA, LLC