Claims Examiner
4 weeks ago
Job DescriptionWe are seeking an experienced Workers’ Compensation Claims Specialist to analyze, manage, and resolve complex workers’ compensation claims.The role involves conducting detailed investigations, determining exposure, managing reserves, and negotiating settlements in compliance with company policies and state regulations.ResponsibilitiesAnalyze and process complex or technically challenging workers' compensation claims by investigating and gathering necessary information to determine claim exposure.Manage claims through well-developed action plans ensuring appropriate and timely resolution.Negotiate claim settlements within designated authority levels.Calculate and assign accurate reserves to claims; maintain reserve adequacy throughout the claim lifecycle.Approve, calculate, and issue timely claim payments and adjustments.Prepare and submit necessary state filings within statutory deadlines.Manage the litigation process, ensuring timely and cost-effective resolutions.Coordinate vendor referrals for additional investigations or litigation management.Apply cost-containment techniques, including vendor partnerships, to reduce claim costs.Manage claim recoveries such as subrogation, Second Injury Fund recoveries, and Social Security/Medicare offsets.Report claims to excess carriers and respond promptly to requests or directions.Maintain professional communication with claimants and clients regarding claim activity.Ensure all claim files are accurately documented and coded.Refer cases to supervisors or management when appropriate.Perform other duties as assigned and support the organization’s quality programs.Experience5+ years of claims management experience or an equivalent combination of education and experience.SkillsStrong knowledge of insurance principles, laws, claim recoveries, cost containment, and disability duration management.Proficient in Microsoft Office applications.Excellent oral and written communication skills.Strong analytical, organizational, and interpersonal skills.Effective negotiation and problem-solving abilities.Ability to work in a team-oriented environment and meet service expectations.Qualification And EducationBachelor’s degree from an accredited college or university preferred.Professional certification in claims or insurance (preferred). #J-18808-Ljbffr
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Casualty Claims Examiner
3 days ago
Toronto, Canada Specialty Claims Canada Full time**Specialty Claims Canada** **“Specialty Claims” **is the in-house claims management department of Specialty Programs Group Canada “SPGC”. Specialty Claims prides itself on managing claims on behalf of the Cansure, Beacon and i3 brands. We manage claims for both our Canadian and London based market partners under a delegated authority. It is the...
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Property Claims Examiners
7 days ago
Toronto, Canada Property Claims Examiners - Full-time (Remote, Ontario) Full timeCompany: Property Claims Examiners - Full-time (Remote, Ontario) International Programs Group (IPG) is an independent third-party administration (TPA) team providing claims services for Lloyd's of London syndicates, domestic insurers, self-insured entities, and organizations with high financial retentions.- Responsibilities: - Examine moderate to...
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Claims Examiner
3 weeks ago
Toronto, Canada AppleOne Employment Services Full timeClaims Examiner Toronto (Remote) $25-27ph 6 month temp with potential to go permanent Our client is seeking an experienced Claims Examiner to join their growing team. If you have hands-on experience in claims adjudication , especially within travel or medical insurance, and you’re passionate about delivering exceptional customer service, we’d love to...
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Claims Examiner
3 weeks ago
Toronto, Canada AppleOne Employment Services Full timeClaims Examiner Toronto (Remote) $25-27ph 6 month temp with potential to go permanent Our client is seeking an experienced Claims Examiner to join their growing team. If you have hands-on experience in claims adjudication, especially within travel or medical insurance, and you’re passionate about delivering exceptional customer service, we’d love to...
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Claims Examiner
3 weeks ago
Toronto, ON, Canada AppleOne Employment Services Full timeClaims Examiner Toronto (Remote)$25-27ph 6 month temp with potential to go permanent Our client is seeking an experienced Claims Examiner to join their growing team. If you have hands-on experience in claims adjudication , especially within travel or medical insurance, and you’re passionate about delivering exceptional customer service, we’d love to hear...
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Claims Examiner
3 weeks ago
Toronto, ON, Canada AppleOne Employment Services Full timeClaims Examiner Toronto (Remote)$25-27ph 6 month temp with potential to go permanent Our client is seeking an experienced Claims Examiner to join their growing team. If you have hands-on experience in claims adjudication , especially within travel or medical insurance, and you’re passionate about delivering exceptional customer service, we’d love to hear...
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Claims Examiner
2 weeks ago
Toronto, ON, Canada AppleOne Employment Services Full timeClaims Examiner Toronto (Remote)$25-27ph 6 month temp with potential to go permanent Our client is seeking an experienced Claims Examiner to join their growing team. If you have hands-on experience in claims adjudication, especially within travel or medical insurance, and you're passionate about delivering exceptional customer service, we'd love to hear from...
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Claims Examiner
1 week ago
Toronto, ON, Canada AppleOne Employment Services Full timeClaims Examiner Toronto (Remote)$25-27ph 6 month temp with potential to go permanent Our client is seeking an experienced Claims Examiner to join their growing team. If you have hands-on experience in claims adjudication , especially within travel or medical insurance, and you’re passionate about delivering exceptional customer service, we’d love to hear...
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Claims Examiner
3 weeks ago
Toronto, Canada AppleOne Employment Services Full timeClaims ExaminerToronto (Remote)$25-27ph 6 month temp with potential to go permanentOur client is seeking an experienced Claims Examiner to join their growing team.If you have hands-on experience in claims adjudication, especially within travel or medical insurance, and you’re passionate about delivering exceptional customer service, we’d love to hear...
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Claims Examiner
2 weeks ago
toronto, Canada AppleOne Employment Services Full timeClaims ExaminerToronto (Remote)$25-27ph 6 month temp with potential to go permanentOur client is seeking an experienced Claims Examiner to join their growing team.If you have hands-on experience in claims adjudication, especially within travel or medical insurance, and you’re passionate about delivering exceptional customer service, we’d love to hear...
