Claims Specialist
Location: Charlotte North Carolina
Description: Zenith Insurance Company is hiring Claims Specialist right now, this job will be placed in North Carolina. For complete informations about this job opportunity please give attention to these descriptions. Investigate, analyze, and determine the extent of company's liability concerning claims and attempt to effect settlement with claimants. Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Calculate benefit payments and approve payment of claims within a certain monetary limit. All tasks are to be performed with the goal of demonstrating Zenith’s superior claims handling expertise.
Responsibilities
The essential functions of this position include, but are not limited to, the following
Under technical direction! , works within significant limits and authority on assignments! of higher technical complexity and coordination. Responsible for claims management of assigned cases within guidelines of published performance standards.
Opens new claims, completes three-point contact, and performs needed investigations to determine compensability as well as possible subrogation or apportionment, according to state and/or Zenith’s timeframes and guidelines.
Sets appropriate reserves according to Zenith’s timeframes and guidelines.
Follows appropriate procedures for system documentation to preserve data integrity.
Monitors and maintains accuracy of reserves over the life of the claim; when new information is received re-evaluates and recommends reserves according to Zenith’s standards.
Creates and executes action plans needed to bring case to closure.
Completes detailed settlement evaluations and recommends appropriate settlement value, within authority; negotiates claim settlements with injured workers and/or injured workers! ’ attorneys.
Maintains regular contact with injured workers, employers and agents to develop positive relationships and establish credibility.
Apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions.Works productively and harmoniously with others on a consistence basis.
Respond positively to direction and criticism of performance.
Consistently maintain professional and appropriate demeanor.
Perform other duties as assigned.
Qualifications
Education, Skills and Experience Requirements
Bachelor’s degree or equivalent combination of training/experience required.
Minimum of (1) year workers’ compensation claims handling experience required.
Basic technical workers’ compensation claims knowledge.
Strong verbal and written communication skills with emphasis on telephone communication required.
Strong math and reading skills required.
Meets all state reg! ulatory standards regarding licensing, continuing education, and other ! requirements.
Attendance Requirements
Due to the nature of the needs in the office, regular and reliable attendance is required. Must be able to work at least 37.5 hours per week, Monday through Friday, and be available as situations arise requiring extended hours.
Physical, Mental & Sensory Requirements
Designated
Special
Designated
Function
Yes/No
Requirements
Yes/No
Function
Degree
Sitting
Yes
Hand Manipulation
Yes
Mathematics
Moderate
Walking
Reaching
Yes
Reading
Moderate
Standing
Grasping
Yes
Verbal
Moderate
Bending
Visual
Yes
Written
Moderate
Kneeling
Auditory
Yes
Reasoning
High
Lifting
Driving
May
The above statements are intended to describe the general nature and level of work performed. They are not intended to be an exhaustive or excl! usive list of the required responsibilities, duties and skills. Management retains the discretion to add to or change the duties and requirements of this position at any time, as needs dictate.
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If you were eligible to this job, please email us your resume, with salary requirements and a resume to Zenith Insurance Company.
If you interested on this job just click on the Apply button, you will be redirected to the official website
This job starts available on: Wed, 08 Jan 2014 19:01:13 GMT