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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.
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Locurile de muncă ale companiei

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.

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

Descriere

  • 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

Cerințe

  • 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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