What are the responsibilities and job description for the Claims Examiner I position at Allianz Partners?
Review claims of a lower to moderate level and related documentation to determine if loss is covered and what benefits apply.
JOB FUNCTIONS
- Key responsibilities which take no less than 10% of overall job time
- Regular, predictable, reliable attendance is an essential function of this position.
- Review claims, identify the incident, determine coverage in accordance with the contract, conclude what, if any benefit applies and the amount to be reimbursed.
- Responsible for paying or rejecting the claim in accordance with the terms and conditions of the insuring agreement.
- Follow-up with customer either by letter, email or telephone call once the claim has been resolved.
- Answer incoming telephone or email inquiries from customers regarding the status of their claim.
- Enter determination and relevant notes into PeopleSoft in accordance with guidelines.
- Collaborate with other departments as needed to verify or obtain missing information.
- Research discrepancies and escalate questionable claims to the Manager.
- Send out claim forms to new customers as needed.
- May perform other duties as assigned.
MINIMUM QUALIFICATIONS
- High school diploma or equivalent diploma.
- Zero (0) to one (1) years experience in a customer service related function.
- Bilingual preferred; may be required based on business need.
- Previous claims experience preferred.
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