Job Overview
We are seeking a detail-oriented and analytical Claims Examiner to join our team. In this role, you will be responsible for reviewing and processing insurance claims, ensuring compliance with relevant laws and regulations. You will play a crucial role in fraud prevention detection, auto estimating, and managing workers' compensation claims. The ideal candidate will possess strong negotiation skills and a solid understanding of financial software to analyze claims effectively.

Responsibilities

Review and evaluate insurance claims for accuracy and completeness.
Analyze claims data to identify potential fraud or discrepancies.
Negotiate settlements with claimants and service providers as necessary.
Utilize auto estimating tools to assess damages and determine claim amounts.
Ensure compliance with laws and regulations throughout the claims process.
Provide exceptional customer service by addressing inquiries and resolving issues related to claims.
Maintain organized records of all claims processed and decisions made.
Collaborate with other departments to facilitate the smooth processing of claims.

Skills

Knowledge of fraud prevention detection techniques.
Proficiency in auto estimating software and financial software applications.
Familiarity with workers' compensation laws and regulations.
Excellent analytical skills to assess complex information effectively.
Strong mathematical, investigative, and problem-solving abilities
Strong negotiation skills to achieve favorable outcomes for all parties involved.
Exceptional organizational skills to manage multiple claims simultaneously.
High level of integrity and ethical standards
Proven customer service skills with the ability to communicate clearly and empathetically.

Join our team as a Claims Examiner, where your expertise will contribute significantly to our commitment to providing excellent service and support to our clients while ensuring compliance with industry standards.

Job Type: Full-time

Pay: From $20.00 per hour

Benefits:

401(k)
Dental insurance
Flexible schedule
Health insurance
Health savings account
Paid time off
Retirement plan
Vision insurance
Work from home

Experience:

Data entry: 2 years (Required)

Location:

Maine (Required)

Work Location: Remote

NAHGA Claim Services

Details

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Claims Examiner