Talent.com
Claims Examiner
Claims ExaminerSunrise Systems • New Haven, Connecticut, United States
Claims Examiner

Claims Examiner

Sunrise Systems • New Haven, Connecticut, United States
job_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
  • serp_jobs.filters_job_card.quick_apply
job_description.job_card.job_description

Job Title : Claims Examiner - Lost Time

Location : New Haven, CT 06511

Duration : 6 months with possibility of extension

Position Type : Hourly contract Position (W2 only)

Note :

  • Job Schedule-Hybrid
  • The position will report and reside in our New Haven, Connecticut office on a 3 / 2 Hybrid Model.
  • Job hours-8 : 30am-5 : 00pm EST
  • 3+ years of Workers' Compensation Lost Time Claim Examiner or Commensurate Experience (Having experience in worker's compensation is not a requirement but a nice thing to have, as long as the skills they do have are transferable.)

Duties and Responsibilities :

  • Handles all aspects of workers' compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process.
  • Reviews claim and policy information to provide background for investigation.
  • Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with insured, claimant and medical providers.
  • Evaluates the facts gathered through the investigation to determine compensability of the claim.
  • Informs insureds, claimants and attorneys of claim denials when applicable.
  • Prepares reports on investigation, settlements, denials of claims and evaluations of involved parties, etc.
  • Timely administration of statutory medical and indemnity benefits throughout the life of the claim.
  • Sets reserves within authority limits for medical, indemnity and expenses and recommends reserve changes to Team
  • Leader throughout the life of the claim.
  • Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them.
  • Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered.
  • Works with attorneys to manage hearings and litigation
  • Controls and directs vendors, nurse case managers, telephonic cases managers and rehabilitation managers on medical management and return to work initiatives.
  • Complies with customer service requests including Special Claims Handling procedures, file status notes and claim reviews.
  • Files workers' compensation forms and electronic data with states to ensure compliance with statutory regulations.
  • Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.
  • Works with in-house Technical Assistants, Special Investigators, Nurse
  • Consultants, Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service.

    • Technical Skills & Competencies :

  • Lost Time Claim Examiner position with prior experience in workers' compensation as a medical only examiner, or commensurate examiner experience in paralegal, short-term / long-term disability, auto personal injury protection / medical injury, general liability or as a claim technical assistant for lost time claims.
  • Requires knowledge of workers' compensation statutes, regulations and compliance.
  • Ability to incorporate data analytics and modeling into daily activities to expedite fair and equitable resolution of claims and claim issues.
  • Exceptional customer service and focus.
  • Ability to openly collaborate with leadership and peers to accomplish goals.
  • Demonstrates a commitment to a career in claims.
  • Exceptional time management and multi-tasking capabilities with consistent follow through to meet deadlines.
  • Use analytical skills to find mutually beneficial solutions to claim and customer issues.
  • Ability to prepare and make exceptional presentations to internal and external customers.
  • Conscientious about the quality and professionalism of work product and relationships with co-workers and clients.
  • Willing to take ownership and tackle obstacles to meet Chubb's quality standards for service, investigation, reserving, inventory management, teamwork, and diversity appreciation.
  • Superior verbal and written communication skills.

    • Experience, Education & Requirements :

  • Experience working in a customer focused, fast-paced, fluid environment
  • Experience utilizing strong communication and telephonic skills
  • Prior experience requiring a high level of organization, follow-up and accountability
  • Prior workers' compensation claim handling experience is a plus but not required
  • Familiarity with claim handling (healthcare, short-term / long-term disability, auto personal injury protection / medical injury, or general liability) is a plus but not required
  • Prior insurance, legal or corporate business experience is a plus but not required
  • AIC, RMA, or CPCU completed coursework or designation(s) is a plus but not required
  • Proficiency with Microsoft Office Products
  • Knowledge of medical terminology is a plus but not required
  • Knowledge of bill processing is a plus but not required
  • Claim Adjuster licenses in Connecticut, New Hampshire, Rhode Island and Vermont, are necessary; however, they are not required at the time of posting for the position. If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure
    • serp_jobs.job_alerts.create_a_job

    Examiner • New Haven, Connecticut, United States

    Job_description.internal_linking.related_jobs
    Remote Claims Adjusters, Examiners, and Investigators - AI Trainer ($60-$100 per hour)

    Remote Claims Adjusters, Examiners, and Investigators - AI Trainer ($60-$100 per hour)

    Mercor • Milford, Connecticut, US
    serp_jobs.filters.remote
    serp_jobs.job_card.full_time
    Role Overview • •Mercor is collaborating with a top-tier AI research group to model real-world claims workflows for property and casualty insurance. We are seeking experienced independent contractors—...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
    Technical Claims Specialist

    Technical Claims Specialist

    The Doctors Company • Unionville, CT, United States
    serp_jobs.job_card.full_time
    TDC Specialty Underwriters, Inc.Excess & Surplus lines subsidiary of The Doctors Company (the nation's largest writer of physicians' malpractice insurance based in Napa, California), offers a broad...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Workers' Compensation Medical Only Claim Manager

    Workers' Compensation Medical Only Claim Manager

    Chubb • New Haven, Connecticut, USA
    serp_jobs.job_card.full_time
    Chubb is currently seeking a Workers Compensation Medical Only Claim Manager for our Northeast New York and New Jersey Region. The successful applicant will be managing a team of examiners who handl...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Managed Care Claim Assistant I

    Managed Care Claim Assistant I

    AmTrust Financial • Southington, CT, United States
    serp_jobs.job_card.full_time
    Managed Care Claim Assistant I.US-CT-Southington | US-TX-Dallas.AmTrust Financial Services, a fast-growing commercial insurance company, has an opportunity for a Claim Assistant I within our Manage...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
    Travel CT Tech - $2,643 to $2,931 per week in Sharon, CT

    Travel CT Tech - $2,643 to $2,931 per week in Sharon, CT

    LRS Healthcare • New Haven, Connecticut, US
    serp_jobs.job_card.full_time
    Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24 / 7 support, and a responsive, traveler-first culture. What are you waiting for? Apply today!.Valid license...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Insurance Claims Environmental

    Insurance Claims Environmental

    Diedre Moire Corp. • Shelton, CT, US
    serp_jobs.job_card.full_time
    Insurance Defense Pollution Claims - Shelton, CT Insurance Claims Specialist Adjuster Examiner Analyst Attorney Environmental Toxic Tort Asbestos Pollution Health Hazard _.REMOTE WORK FROM HOME AVA...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Cath Lab Tech - $2,452 to $2,718 per week in Danbury, CT

    Travel Cath Lab Tech - $2,452 to $2,718 per week in Danbury, CT

    LRS Healthcare • New Haven, Connecticut, US
    serp_jobs.job_card.full_time
    Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24 / 7 support, and a responsive, traveler-first culture. What are you waiting for? Apply today!.Valid license...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Surgical Tech - $1,796 per week in Port Jefferson, NY

    Travel Surgical Tech - $1,796 per week in Port Jefferson, NY

    AlliedTravelCareers • Port Jefferson, NY, US
    serp_jobs.job_card.full_time +1
    AlliedTravelCareers is working with Focus Staff to find a qualified Surg Tech in Port Jefferson, New York, 11777!.The ideal candidate will have at least 1 year of experience in a Surg Tech setting....serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Travel Sterile Processing Tech - $1,331 to $1,476 per week in Port Jefferson, NY

    Travel Sterile Processing Tech - $1,331 to $1,476 per week in Port Jefferson, NY

    AlliedTravelCareers • Port Jefferson, NY, US
    serp_jobs.job_card.full_time
    AlliedTravelCareers is working with LRS Healthcare to find a qualified Sterile Processing Tech in Port Jefferson, New York, 11777!. Ready to start your next travel adventure? LRS Healthcare offers a...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel CT Tech - $2,073 to $2,317 per week in Mount Clemens, CT

    Travel CT Tech - $2,073 to $2,317 per week in Mount Clemens, CT

    AlliedTravelCareers • New Haven, Connecticut, US
    serp_jobs.job_card.full_time
    AlliedTravelCareers is working with Prime Time Healthcare to find a qualified CT Tech in Mount Clemens, Connecticut, 48043!. Now Hiring : Allied Healthcare CT - Mount Clemens, MI.Contact us for Pay I...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel X-Ray Tech - $2,355 to $2,555 per week in New Haven, CT

    Travel X-Ray Tech - $2,355 to $2,555 per week in New Haven, CT

    AlliedTravelNetwork • New Haven, Connecticut, US
    serp_jobs.job_card.full_time
    AlliedTravelNetwork is working with Titan Medical Group to find a qualified X-Ray Tech in New Haven, Connecticut, 06524!. ARRT(R) / BCLS / BLS - American Heart Association.Titan Medical is looking for t...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Echo Tech - $2,392 to $2,673 per week in New London, CT

    Travel Echo Tech - $2,392 to $2,673 per week in New London, CT

    Prime Time Healthcare • New Haven, Connecticut, US
    serp_jobs.job_card.full_time
    Now Hiring : Allied Healthcare Ultrasound Echo - New London, CT.Contact us for Pay Information.Actual amount dependent upon market adjustments. Are you a passionate Allied Healthcare professional loo...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Senior Claim Examiner-Workers Compensation

    Senior Claim Examiner-Workers Compensation

    Chubb • New Haven, Connecticut, USA
    serp_jobs.job_card.full_time
    Chubb is currently seeking a Workers Compensation Lost Time Senior Claim Examiner for our Northeast New York and New Jersey successful applicant will be handling claims from Vermont New Hampshire ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel Radiology Tech - $2,164 to $2,419 per week in Wilton, CT

    Travel Radiology Tech - $2,164 to $2,419 per week in Wilton, CT

    AlliedTravelNetwork • New Haven, Connecticut, US
    serp_jobs.job_card.full_time
    AlliedTravelNetwork is working with Prime Time Healthcare to find a qualified Rad Tech in Wilton, Connecticut, 06897!.Now Hiring : Allied Healthcare Rad Tech - Wilton, CT. Contact us for Pay Informat...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel CT Tech - $2,348 to $2,603 per week in Greenwich, CT

    Travel CT Tech - $2,348 to $2,603 per week in Greenwich, CT

    LRS Healthcare • New Haven, Connecticut, US
    serp_jobs.job_card.full_time
    Ready to start your next travel adventure? LRS Healthcare offers a full benefits package, 24 / 7 support, and a responsive, traveler-first culture. What are you waiting for? Apply today!.Valid license...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
    Travel CT Tech - $2,833 per week in Guilford, CT

    Travel CT Tech - $2,833 per week in Guilford, CT

    Triage Staffing LLC • New Haven, Connecticut, US
    serp_jobs.job_card.full_time
    Travel Radiology : CT Tech Guilford.Shift Details : 8H Days (12 : 00 AM-12 : 00 PM).Length : 12 WEEKS 12 weeks.Apply for specific facility details.serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Workers' Compensation Lost Time Senior Claim Examiner

    Workers' Compensation Lost Time Senior Claim Examiner

    Chubb • New Haven, Connecticut, United States
    serp_jobs.job_card.full_time
    Chubb is currently seeking a Workers’ Compensation Lost Time Senior Claim Examiner for our Northeast, New York, and New Jersey region. The successful applicant will be handling claims from Vermont, ...serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
    Travel CT Tech - $2,833 per week in Guilford, CT

    Travel CT Tech - $2,833 per week in Guilford, CT

    AlliedTravelNetwork • New Haven, Connecticut, US
    serp_jobs.job_card.full_time
    AlliedTravelNetwork is working with Triage Staffing LLC to find a qualified CT Tech in Guilford, Connecticut, 06437!.Travel Radiology : CT Tech Guilford. Shift Details : 8H Days (12 : 00 AM-12 : 00 PM)....serp_jobs.internal_linking.show_more
    serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted