Claims Examiner I
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Job Description
Claims Examiner I conducting claims intake and investigation while ensuring compliance with procedures. Collaborating with senior claims personnel and maintaining electronic case files.
Responsibilities:
- Conduct initial intake and review of affirmative claims cases and related documentation
- Request and obtain police reports, accident reports, medical records, insurance information, and other supporting documentation
- Identify potential insurance carriers and gather information necessary to support claim development
- Communicate professionally with claimants, insurance representatives, medical providers, attorneys, and government personnel
- Perform basic legal and insurance research utilizing available resources such as LexisNexis, Westlaw, and public databases
- Draft initial Notices of Claim, standard demand letters, and routine correspondence for supervisory review
- Maintain accurate electronic case files within the Affirmative Claims Management Program (ACMP) or similar claims management systems
Requirements:
- Associate's Degree or Bachelor's Degree preferred
- Minimum of 1-3 years of professional experience in claims processing, insurance operations, legal support, customer service, case management, or related fields
- Excellent written and verbal communication skills
- Strong customer service and interpersonal communication skills
- Strong organizational skills and attention to detail
- Proficiency with Microsoft Office Suite (Word, Excel, Outlook, and Teams)
Benefits:
- Health insurance
- 401(k) matching
- Paid time off
- Professional development
- Remote work options
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