Claims Examiner jobs in Kentucky

Claims Examiner reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner work is closely managed. Works on projects/matters of limited complexity in a support role. To be a Claims Examiner typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)

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Medical Only Claims Examiner
  • Harford Mutual Insurance Group
  • Louisville, KY OTHER
  • Job Details

    Level:    Entry
    Job Location:    Midwest Location - Louisville, KY
    Position Type:    Full Time
    Education Level:    4 Year Degree
    Salary Range:    Undisclosed
    Travel Percentage:    Negligible
    Job Category:    Insurance

    Description

    WHO WE ARE:

    Harford Mutual Insurance Group is a growing, dynamic community partner located in Bel Air in Harford County, Maryland, offering a positive, diverse, and inclusive work environment with a rich company culture. We provide commercial property and casualty insurance products and services to a regional market. Founded in 1842 on the principles of mutuality for our business clients, our agents, and our company, we believe in insuring opportunity through mutual success® and invite our employees to continue that tradition with respect, integrity, exemplary service, and personal responsibility.

     

    THE OPPORTUNITY

    The Medical-Only Examiner works within specific limits and authority on low complexity claim assignments.  They confirm coverage, contact the insured to confirm the incident, then collect medical bills and issue payment as quickly as possible.  The claims handled by a medical only examiner are on a fast track basis and require limited investigation, with a goal of creating a positive experience for the policyholder and injured worker.

     

     

    WHAT YOU’LL DO:

    Receive, review and timely process claims.

    •     Proper claim coverage and file documentation.

    •     Enter and update claims in claim management system.

    •     Establish and update claim reserves promptly.

    •     Provide prompt claim acknowledgement to the policyholder.

    •     Contact medical providers promptly and request itemized billing statements and medical records.

    •     Resolve claims by issuing prompt payment, or denial of claim.

    •     Maintain claim diary and comply with departmental diary procedures.

    •     Comply with the Unfair Claims Practice laws in the handling of all claims.

    •     Respond to claims status inquiries.

    •     Continuing education on insurance and claims matters.

    •     Performs other duties or special projects as required or as assigned by a supervisor.

     

    WHAT YOU’LL BRING:

    • Four-year college degree; or Associate Degree plus 2 years of commensurate work experience to role.
    • 0 – 3 years of experience in claims
    • AINS or AIC preferred; or willingness to participate in continuing education

     

    WHO YOU ARE:

    • Ability to understand and analyze policy coverages
    • Strong collaborating skills, and an ability to work effectively both independently and as part of a team
    • Comfortable in a fast-paced environment; high energy, self-motivated and proactive
    • Excellent communication and interpersonal skills
    • Ability to multitask, and be flexible regarding workload and assignments
    • Ability to exercise judgment
    • Experience with Microsoft Windows, Outlook, and Excel or transferable software packages.
    • Holds and maintains appropriate adjuster licensing and certification(s) in assigned territories and will obtain additional licensing based upon business needs

    Physical Requirements:

    The physical demands are minimal and typical of similar jobs in comparable organizations.

     

    Americans with Disabilities Act (ADA):

    Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties of the position.

     

     

    The statements herein are intended to describe the general nature and level of work being performed by employees, and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified.  Furthermore, they do not establish a contract for employment and are subject to change at the discretion of Harford Mutual

    Visit our Careers Page for more information on our competitive compensation/benefits packages.


  • Just Posted

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Sr. Claims Examiner-Workers' Compensation
  • Harford Mutual Insurance Group
  • Louisville, KY OTHER
  • Job Details Level: Experienced Job Location: Midwest Location - Louisville, KY Position Type: Full Time Education Level: 4 Year Degree Salary Range: Undisclosed Travel Percentage: Up to 25% WHO WE ARE...
  • Just Posted

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Senior Workers' Compensation Claims Examiner | Remote
  • KING'S INSURANCE STAFFING LLC
  • Louisville, KY FULL_TIME
  • Our client is seeking to add a Senior Workers’ Compensation Claims Examiner to their Kentucky operations. This role will consist of handling mid to complex Workers’ Compensation Lost Time claims throu...
  • 1 Day Ago

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Field Roof Inspector - Louisville, KY
  • Hancock Claims Consultants Technicians
  • Louisville, KY CONTRACTOR
  • Hancock Claims Consultants specialize in Ladder Assist and Property Inspection Services, collaborating directly with numerous insurance agencies for efficient claims management.At Hancock, we are at t...
  • 13 Days Ago

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Kentucky Independent Auto Appraiser
  • Complete Claims Service
  • , KY CONTRACTOR
  • Complete Claims Service, LLC seeks Independent Auto Damage Appraisers across the state of Kentucky. This is a job for independent appraisers only NOT FOR INSURANCE ADJUSTERS! We are looking to hire pr...
  • 2 Months Ago

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Title Examiner
  • Drees Homes
  • Fort Mitchell, KY FULL_TIME
  • Overview: Drees Homes is a family-owned home building company with a passion for making custom homes easy. For 95 years, we have taken care of our employees and our customers. It’s why we rank as the ...
  • 28 Days Ago

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Claims Examiner
  • Berkley
  • Stamford, CT
  • Company Details: Berkley Re is a specialty P&C reinsurer that provides solutions for insurers with a successful business...
  • 5/11/2024 12:00:00 AM

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Claims Examiner
  • Polikov Recruitment Solutions
  • We are currently searching for an experienced Claims Examiner in Pheonix, AZ. Our client is an A+ rated E&S carrier serv...
  • 5/10/2024 12:00:00 AM

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Claims Examiner
  • Carl Warren & Company
  • COMPANY OVERVIEW: Carl Warren & Company is a leading nationwide Third-Party Administrator (TPA) founded in 1944. Carl Wa...
  • 5/9/2024 12:00:00 AM

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Claims Examiner
  • Erie Insurance
  • Erie, PA
  • Division or Field Office: Claims Division Department of Position: Corporate Claims Department Work from: ERIE's Footprin...
  • 5/9/2024 12:00:00 AM

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Claims Examiner
  • Quality Distribution, Inc.
  • Tampa, FL
  • Quality Carriers, Inc. is the nation's #1 tank trucking company. We transport a broad range of chemical products and pro...
  • 5/9/2024 12:00:00 AM

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Claims Examiner
  • LanceSoft
  • Brea, CA
  • Job Description: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to ...
  • 5/9/2024 12:00:00 AM

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Claims Examiner
  • Auto-Owners Insurance
  • Lansing, MI
  • A career at Auto-Owners is challenging and rewarding. Our group of caring associates create financial security by helpin...
  • 5/9/2024 12:00:00 AM

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Claims Examiner
  • Horace Mann
  • Addison, TX
  • (Hybrid) Addison, TX Hybrid work position for a Claims Examiner responsible for set-up and processing claims while provi...
  • 5/9/2024 12:00:00 AM

Kentucky (/kənˈtʌki/ (listen) kən-TUK-ee), officially the Commonwealth of Kentucky, is a state located in the east south-central region of the United States. Although styled as the "State of Kentucky" in the law creating it, (because in Kentucky's first constitution, the name state was used) Kentucky is one of four U.S. states constituted as a commonwealth (the others being Virginia, Pennsylvania, and Massachusetts). Originally a part of Virginia, in 1792 Kentucky became the 15th state to join the Union. Kentucky is the 37th most extensive and the 26th most populous of the 50 United States. Ke...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner jobs
$45,151 to $59,874