What are the responsibilities and job description for the Claims Examiner - Auto position at Synectics Inc?
Job Description
Job Description
Job Description :
To analyze and process complex auto and commercial transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.
Processes complex auto commercial and personal line claims, including bodily injury and ensures claim files are properly documented and coded correctly.
Responsible for litigation process on litigated claims.
Coordinates vendor management, including the use of independent adjusters to assist the investigation of claims.
Reports large claims to excess carrier(s).
Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
Identifies and pursues subrogation and risk transfer opportunities; secures and disposes of salvage.
Communicates claim action / processing with insured, client, and agent or broker when appropriate.
Supports the organization's quality program(s).
Travels as required.
QUALIFICATIONS
Bachelor's degree from an accredited college or university preferred.
Professional certification as applicable to line of business preferred.
Secure and maintain the State adjusting licenses as required for the position.
5 years of claims management experience or equivalent combination of education and experience required to include in-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws.
In-depth knowledge of personal and commercial line auto policies, coverage's, principles, and laws
Knowledge of medical terminology for claim evaluation and Medicare compliance
Knowledge of appropriate application for deductibles, sub-limits, SIR's, carrier and large deductible programs.
Strong oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Strong organizational skills
Strong interpersonal skills
Good negotiation skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations
Mental : Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
Auto casualty
Experienced in complex liability and coverage.
TPA experience a plus.
Bodily injury / uninsured / underinsured motorist handling experience to include demonstrable(fatality, fractures, traumatic brain injury) injury handling.
threshold handling up to 1 million.
No fault (Personal Injury Protection) experience.
Licensed in the contiguous 48 states.
Litigation handling experience pertaining to BI / UM / UIM (Not all candidates will need this but a minimum of 3 will need litigation handling experience)
Auto Physical Damage handling experience preferred.
Experience working in a fast paced environment, participating in and presenting cases to both internal and external stakeholders.
Benefits :
Healthcare Insurance : Synectics offers eligible employees and their dependents healthcare coverage through BlueCross BlueShield of Illinois. Eligibility begins on the 1st day of the calendar month following 60 days of continuous full time employment with Synectics. Premiums are subsidized by Synectics.
Dental Insurance : Synectics offers eligible employees and their dependents a dental plan through MetLife. Eligibility begins on the 1st day of the calendar month following 60 days of continuous full time employment with Synectics.
Vision Insurance : Synectics offers eligible employees vision insurance through VSP. Eligibility begins on the 1st day of the calendar month following 60 days of continuous full time employment with Synectics.401(k) Plan : The Synectics Inc. Investment Savings Retirement Plan. Synectics offers all employees who are 21 years of age or older the opportunity to invest in the 401(k) Plan on the first enrollment date that is at least 30 days after employment begins. Enrollment dates are each January 1st, April 1st, July 1st, and October 1st.
Technical Certification Bonus : Synectics is pleased to award its employees a bonus of up to $500 for an approved professional certification. In determining the bonus amount, Synectics will consider the cost of the test(s) for any certification relating to your current position, achieved during your employment with us. Only one Certification Bonus per calendar year may be awarded per employee. Only current, active employees will be eligible to receive this bonus. It will be awarded 90 days after the Synectics office has received documentation confirming the successful completion of the certification.
Synectics is an equal opportunity employer.
