TRISTAR Insurance Group
TRISTAR Insurance Group
TRISTAR Insurance Group ish beruvchilar, sug‘urta kompaniyalari va davlat tashkilotlariga sug‘urtani ma’muriy boshqarish hamda risklarni boshqarish xizmatlarini ko‘rsatuvchi milliy uchinchi tomon ma’muridir. Kompaniya mulk va baxtsiz hodisalardan sug‘urtalash dasturlarini, xodimlar mehnatiga oid kompensatsiyalarni, umumiy va avtomobil javobgarligini, boshqariladigan tibbiy xizmatlarni, ta’til va nogironlikni boshqarishni, xodimlarning guruh imtiyozlarini ma’muriy boshqarishni hamda ish joyidagi xavfsizlikni qo‘llab-quvvatlaydi. Uning boshqariladigan tibbiy xizmatlar bo‘yicha imkoniyatlariga hisob-kitoblarni tekshirish, holatlarni boshqarish, xizmatlardan foydalanishni ko‘rib chiqish, hamshiralik triaji va dorixona imtiyozlarini boshqarish kiradi. TRISTAR texnologiya bilan ta’minlangan operatsiyalarni moslashtirilgan xizmat ko‘rsatish bilan birlashtirib, mijozlarga murakkab sug‘urta va xodimlar imtiyozlari ehtiyojlari doirasida risklarni boshqarishga yordam beradi.

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.

Tavsif

  • 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

Talablar

  • 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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