Claim Examiner I
$53,300–$67,000 year
HybridLas Vegas, Nevada, United States
Job Summary
Investigate Worker's Compensation claims by contacting insureds, claimants, witnesses, and producers to gather evidence including medical records, police reports, and photographs. Analyze coverage applicability under policy and statutes, establish and adjust reserves based on case facts and company standards, and negotiate litigated claims while collaborating with internal legal counsel. Coordinate with Managed Care and Medical resources to authorize treatment plans and manage accurate billing. Document findings in clear, fact-based Claims files and leverage critical thinking skills to verify and interpret root issues. Manage time and diary entries effectively in a fast-paced environment. This hybrid position is based in the Las Vegas, NV office.
Required Qualifications
- Bachelor's degree or equivalent experience
- 3+ years claims handling experience
- State licensure as required
- Demonstrated proficiency with MS Office suites
- Demonstrated skills in investigation, evaluation and negotiation
- Strong knowledge of insurance theory and practices
- Ability to travel is required for some positions
Desired Qualifications
- 2+ years of specific Worker's Compensation experience preferred
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