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

Manage complex professional liability claims for TRISTAR Insurance Group in a fully remote Texas role. Responsibilities include coverage analysis, liability investigations, reserve evaluation, settlement recommendations, and claim resolution.

विवरण

  • Administer professional liability claims from initial notice through closure while following assigned authority and company procedures
  • Analyze policies, endorsements, and vehicle schedules to establish coverage for loss, damage, or injury
  • Investigate claims, including litigated matters, and guide them through final resolution
  • Communicate regularly with claimants and their attorneys or other legal representatives
  • Advise clients on loss exposure, reserves, and settlement approaches
  • Process, evaluate, and finalize assigned professional liability claims
  • Interpret policy language and issue coverage decisions
  • Coordinate and supervise external investigative vendors
  • Collaborate with clients, client counsel, and investigative providers to move claims toward resolution
  • Keep claim diaries current throughout the claim lifecycle
  • Evaluate exposure and review reserve and settlement recommendations
  • Produce detailed Loss Reports covering liability and damages
  • Identify and begin subrogation or risk-transfer recovery actions when appropriate
  • Maintain complete records of correspondence, reports, conversations, and claim decisions
  • Deliver responsive client service
  • Support supervisors and the Claims Department with assigned work and special projects
  • Work from home under the Area Manager’s direction and report to the Claim Supervisor and/or Area Manager

आवश्यकताएँ

  • Bachelor’s degree in a related discipline preferred, plus at least five years of relevant experience, or an equivalent combination of education and experience
  • Working knowledge of coverage, statutory requirements, and medical terminology
  • Strong analytical ability
  • Clear written and verbal communication skills, including the ability to explain technical information to claimants, clients, and colleagues
  • Confidence working with people across all levels of a business
  • Capacity to independently manage highly complex claims effectively
  • Proficiency with Microsoft Word and Excel preferred
  • Current New York State Independent Adjuster license
  • High school diploma or GED

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