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।

Workers' Compensation Claims Examiner II - Hybrid in Irving

Manage a caseload of 150–180 moderate-to-complex workers’ compensation indemnity claims from intake through resolution. Responsibilities include reserves, settlements, escalations, defense counsel coordination, and litigation oversight.

विवरण

  • Handle moderate-to-complex workers’ compensation indemnity claims from initial assignment through closure
  • Apply independent judgment when managing routine and complex claims
  • Consult a supervisor on unusual, high-exposure, or sensitive claims
  • Maintain a caseload of approximately 150–180 workers’ compensation claims
  • Evaluate losses and set appropriate reserves
  • Approve payments and settlements within delegated authority
  • Escalate significant exposures, unusual compensability questions, sensitive client matters, and decisions beyond delegated authority
  • Engage defense counsel when claim circumstances warrant
  • Track and oversee litigation activity
  • Discuss major legal developments and settlement approaches with the supervisor

आवश्यकताएँ

  • Bachelor’s degree in a related discipline is preferred
  • Three to five years of relevant experience
  • An equivalent combination of education and experience may be considered
  • Working knowledge of statutory regulations and medical terminology
  • Strong analytical ability
  • Excellent written and verbal communication skills, including the ability to explain technical information to claimants, clients, and staff
  • Ability to work effectively with people across all levels of the business
  • Ability to independently manage highly complex claims effectively
  • Proficiency with Microsoft Word and Excel is preferred
  • State-required certifications and/or licenses must be obtained as applicable

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