No-Fault Examiner (Hybrid)
$44,885–$69,821 year
HybridSherburne, New York, United States
Job Summary
Verify policy coverage, determine eligibility and exclusions, and accurately reserve claims for potential exposure based on injuries sustained. Conduct thorough investigations to gather information for proper resolution, identify fraud indicators, and process payments or denials in accordance with regulations. Manage cycle times, handle customer inquiries via phone and email, and guide claimants through each stage of the process while maintaining accurate payment worksheets. Testify in court when necessary and maintain current knowledge of insurance best practices and fraud trends. Work 40 hours per week with a market range of $44,885 to $69,821.
Required Qualifications
- High school diploma, or equivalent
- Full working knowledge and understanding of basic insurance principals and policies
- Claims procedures
- Regulations
- Best practices
- Good personal computer skills including electronic mail
- Record keeping
- Claims systems
- Mitchell DecisionPoint
- Understanding of medical injuries and how they relate to claim file management
- Strong interpersonal skills
- Ability to work within a team or independently without direct supervision
- Willingness and ability to engage in authentic conversations
- Good written and verbal communication skills
- Active listening
- Organized
- Detail oriented
- Ability to multi-task and prioritize
- Strong evaluation and decision-making abilities
- Ability to handle stress professionally, calmly, and effectively
- Critical thinking
- Positive and professional attitude
- Willingness to pursue professional development
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