TRISTAR Insurance Group
TRISTAR Insurance Group
TRISTAR Insurance Group एक राष्ट्रीय थर्ड-पार्टी एडमिनिस्ट्रेटर है, जो नियोक्ताओं, बीमा कंपनियों और सार्वजनिक संस्थाओं को बीमा प्रशासन तथा जोखिम प्रबंधन सेवाएँ प्रदान करता है। कंपनी संपत्ति और दुर्घटना बीमा कार्यक्रमों, कर्मचारियों के मुआवज़े, सामान्य और ऑटो देयता, प्रबंधित देखभाल, अनुपस्थिति और दिव्यांगता प्रबंधन, कर्मचारी समूह लाभ प्रशासन तथा कार्यस्थल सुरक्षा में सहायता करती है। इसकी प्रबंधित देखभाल क्षमताओं में बिल समीक्षा, केस प्रबंधन, उपयोग समीक्षा, नर्स ट्रायेज और फार्मेसी लाभ प्रबंधन शामिल हैं। TRISTAR तकनीक-सक्षम संचालन को अनुकूलित सेवा के साथ जोड़कर ग्राहकों को जटिल बीमा और कर्मचारी लाभ संबंधी आवश्यकताओं के बीच जोखिम प्रबंधित करने में सहायता करता है।

Professional Liability Claims Examiner III - Texas Remote

Handle complex professional liability claims remotely in Texas, from coverage review and investigation through settlement and closure. The role includes reserve evaluation, litigation-related claims, client communication, and recovery assessment.

विवरण

  • Manage professional liability claims from initial assignment through resolution in line with authority limits and company procedures.
  • Review policies, endorsements, and vehicle schedules to establish coverage for loss, damage, or injury.
  • Investigate claims, including litigated matters, through final disposition.
  • Communicate regularly with claimants and their attorneys.
  • Explain loss exposure, reserve positions, and settlement strategy recommendations to clients.
  • Process, review, and close assigned claims.
  • Interpret policy language and make coverage decisions.
  • Coordinate and oversee external investigative vendors.
  • Collaborate with clients, client counsel, and investigative providers to move claims forward.
  • Keep claim diaries current throughout the claim lifecycle.
  • Evaluate exposure and develop reserve and settlement recommendations.
  • Produce detailed loss reports addressing liability and damages.
  • Identify and begin subrogation or risk-transfer recovery actions when appropriate.
  • Record correspondence, reports, discussions, and decisions in claim files.
  • Deliver responsive service to clients.
  • Support supervisors and the Claims Department with assigned tasks and special projects.
  • Complete additional duties as directed.
  • Work from home under the Area Manager's supervision while reporting to the Claim Supervisor and/or Area Manager.

आवश्यकताएँ

  • A bachelor's degree in a related discipline is preferred.
  • At least five years of relevant professional experience.
  • A comparable combination of education and experience may be considered.
  • Technical understanding of coverage, statutory requirements, and medical terminology.
  • Strong analytical capability.
  • Excellent written and verbal communication skills, including the ability to explain technical information to claimants, clients, and colleagues.
  • Ability to work effectively with people across all levels of a business.
  • Capacity to manage highly complex claims independently and effectively.
  • Working proficiency with Microsoft Word and Excel is preferred.
  • Current Independent Adjuster license in New York State.
  • Ability to perform sedentary or light work and the specified mental, visual, physical, and communication functions.

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