What are the responsibilities and job description for the Claims Examiner-Lost Time position at Robert Half?
We are offering a short term contract employment opportunity for a Claims Examiner-Lost Time in New Haven, Connecticut. This role primarily functions in the insurance industry and involves handling all aspects of workers compensation lost time claims. The successful candidate will be expected to maintain strong customer relations throughout the process, from setup to case closure.
Responsibilities:
• Handling all components of workers compensation lost time claims, from initiation to closure, maintaining strong customer relations throughout.
• Thoroughly reviewing claim and policy information to establish a basis for investigation.
• Conducting comprehensive investigations, obtaining facts and statements from insured claimants and medical providers.
• Evaluating facts gathered through investigations to determine the compensability of the claim.
• Informing insureds, claimants, and attorneys of claim denials, when applicable.
• Preparing reports on investigations, settlements, denials of claims, and evaluations of involved parties.
• Administering statutory medical and indemnity benefits in a timely manner throughout the life of the claim.
• Setting reserves for medical, indemnity, and expenses within authority limits and recommending reserve changes to Team Leader.
• Regularly reviewing claim status and making recommendations to Team Leader to discuss problems and remedial actions.
• Working with attorneys to manage hearings and litigation.
• Directing vendors, nurse case managers, and rehabilitation managers on medical management and return to work initiatives.
• Complying with customer service requests, including special claims handling procedures, file status notes, and claim reviews.
• Filing workers compensation forms and electronic data with states to ensure compliance with statutory regulations.
• Maximizing recovery opportunities by referring appropriate claims to subrogation and securing necessary information.
• Collaborating with in-house Technical Assistants, Special Investigators, Nurse Consultants, Telephonic Case Managers, and Team Supervisors to exceed customer's expectations for exceptional claims handling service.• Proficient in Customer Service
• Strong Communication skills
• Understanding of Procedures and Policies
• Knowledge of Compliance and Quality standards
• Experience in Human Resources (HR) Administration
• Familiarity with Insurance industry
• Ability to create and deliver Presentations
• Knowledge about Time management
• Understanding of Medical Coverage and Benefit Functions
• Demonstrated Leadership Skills
• Experience working with Vendors
• Familiarity with Claim Administration
• Understanding of Regulation in the insurance sector
• Experience with Expense Reporting and Financial Notes
• Excellent Time Management skills
• Knowledge of Consumer Electronics
• Ability to work in a Team
• Proficiency in Microsoft Office Suites
• Experience in Litigation
• Familiarity with HealthCare.gov
• Ability to Ensure Compliance
Responsibilities:
• Handling all components of workers compensation lost time claims, from initiation to closure, maintaining strong customer relations throughout.
• Thoroughly reviewing claim and policy information to establish a basis for investigation.
• Conducting comprehensive investigations, obtaining facts and statements from insured claimants and medical providers.
• Evaluating facts gathered through investigations to determine the compensability of the claim.
• Informing insureds, claimants, and attorneys of claim denials, when applicable.
• Preparing reports on investigations, settlements, denials of claims, and evaluations of involved parties.
• Administering statutory medical and indemnity benefits in a timely manner throughout the life of the claim.
• Setting reserves for medical, indemnity, and expenses within authority limits and recommending reserve changes to Team Leader.
• Regularly reviewing claim status and making recommendations to Team Leader to discuss problems and remedial actions.
• Working with attorneys to manage hearings and litigation.
• Directing vendors, nurse case managers, and rehabilitation managers on medical management and return to work initiatives.
• Complying with customer service requests, including special claims handling procedures, file status notes, and claim reviews.
• Filing workers compensation forms and electronic data with states to ensure compliance with statutory regulations.
• Maximizing recovery opportunities by referring appropriate claims to subrogation and securing necessary information.
• Collaborating with in-house Technical Assistants, Special Investigators, Nurse Consultants, Telephonic Case Managers, and Team Supervisors to exceed customer's expectations for exceptional claims handling service.• Proficient in Customer Service
• Strong Communication skills
• Understanding of Procedures and Policies
• Knowledge of Compliance and Quality standards
• Experience in Human Resources (HR) Administration
• Familiarity with Insurance industry
• Ability to create and deliver Presentations
• Knowledge about Time management
• Understanding of Medical Coverage and Benefit Functions
• Demonstrated Leadership Skills
• Experience working with Vendors
• Familiarity with Claim Administration
• Understanding of Regulation in the insurance sector
• Experience with Expense Reporting and Financial Notes
• Excellent Time Management skills
• Knowledge of Consumer Electronics
• Ability to work in a Team
• Proficiency in Microsoft Office Suites
• Experience in Litigation
• Familiarity with HealthCare.gov
• Ability to Ensure Compliance
Salary : $30 - $33
