LogoFresh Jobs Ahead
TRISTAR Insurance Group
TRISTAR Insurance Group
501 – 1.000 Angajați
Asistență medicalăConsultanțăLogistică
TRISTAR Insurance Group este un administrator național de servicii de asigurare pentru terți, care oferă angajatorilor, asigurătorilor și entităților publice servicii de administrare a asigurărilor și de gestionare a riscurilor. Compania sprijină programe pentru bunuri și răspundere civilă, compensații pentru accidente de muncă, răspundere civilă generală și auto, îngrijire medicală coordonată, gestionarea absențelor și dizabilităților, administrarea beneficiilor de grup pentru angajați și siguranța la locul de muncă. Capacitățile sale de îngrijire medicală coordonată includ verificarea facturilor, gestionarea cazurilor, evaluarea utilizării serviciilor, triajul efectuat de asistente medicale și administrarea beneficiilor farmaceutice. TRISTAR combină operațiunile susținute de tehnologie cu servicii adaptate pentru a ajuta clienții să gestioneze riscurile asociate unor nevoi complexe de asigurare și de beneficii pentru angajați.
LinkedIn
Locurile de muncă ale companiei

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.

USStatele Unite ale AmericiiTXTexas
80.000 $ – 95.000 $ / an
RemoteNormă întreagăNivel mediuSeniorLimbă Obligatorie: englezăSpecialist în daune

Descriere

  • 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.

Cerințe

  • 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.

Locuri de muncă similare

PMA Consultants

NetSuite Project Accounting Specialist

PMA Consultants
201 – 500 Angajați
Sponsor pentru viza H1BAsistență medicalăIndustria prelucrătoareLogistică
USStatele Unite ale AmericiiMIMichigan
83.082 $ – 97.621 $ / an
HibridNormă întreagăNivel mediuSeniorLimbă Obligatorie: englezăManager contabilitate
ERPOracle

Manage NetSuite billing and project financial records for PMA Consultants’ construction consulting work, coordinating with project managers, finance, operations, and clients. Track budgets, invoices, expenses, and payment issues across the project lifecycle.

Deschide