TRISTAR Insurance Group
TRISTAR Insurance Group
TRISTAR Insurance Group — жұмыс берушілерге, сақтандыру компанияларына және мемлекеттік ұйымдарға сақтандыруды әкімшілендіру мен тәуекелдерді басқару қызметтерін ұсынатын ұлттық деңгейдегі үшінші тарап әкімшісі. Компания мүлік пен жазатайым оқиғалардан сақтандыру бағдарламаларын, еңбекке байланысты өтемақыны, жалпы және автокөлік жауапкершілігін, басқарылатын медициналық көмекті, еңбек демалысы мен мүгедектікті басқаруды, қызметкерлердің топтық жеңілдіктерін әкімшілендіруді және жұмыс орнындағы қауіпсіздікті қолдайды. Басқарылатын медициналық көмек бағытындағы мүмкіндіктеріне шоттарды тексеру, жағдайды басқару, медициналық қызметті пайдалану тиімділігін тексеру, мейіргерлік триаж және дәріхана жеңілдіктерін басқару кіреді. TRISTAR технологияға негізделген операцияларын жекелендірілген қызмет көрсету тәсілімен ұштастырып, клиенттеріне күрделі сақтандыру және қызметкерлерге арналған жеңілдіктер қажеттіліктері аясында тәуекелдерді басқаруға көмектеседі.

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.

Сипаттама

  • 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

Талаптар

  • 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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