Eberl Claims Service is a subsidiary of Engle Martin & Associates, a national insurance services provider. If you are looking for an exciting opportunity to join a growing company that highly values its people, team work, and excellence in customer service then Eberl is right for you! We are seeking to hire a Sr. Claims Examiner based in Dallas, TX. At Eberl, we provide insurance claims handling solutions that exceed client expectation and as such, have raised the bar for the entire industry. We pride ourselves on hiring and retaining top adjuster talent, allowing us to maintain our status as an industry leader. Since 1987, Eberl has been Adjusting the Standard!
Summary of Job Purpose
Senior Claims Examiner is responsible for driving file quality and production standards, The Senior Claims Examiner reports to the QA Manager.
- Assists with the Oversite of the File Examination Team:
- Assist QA Manager with creating and documenting File Examiner Workflows and Procedures.
- Monitor File Examiners production logs to ensure that that the majority of their time is spent reviewing files.
- Monitor review queue volume, assign claims to file examiners.
- Monitor review Queue to ensure that files are reviewed in the required timeframe. Investigate and report any delays and ensure that file is brought back into compliance.
- Remove claims from queue that do not require file examination.
- Manage General Client Data Sets for files that need be closed.
- Audit File Examiners work weekly to ensure that the Examiner is reviewing claim in accordance with the guidelines of that specific client.
- Track claim file rejections from the client, identify any issues that may have not been addressed in the review process.
- Track and Review QA Escalation rule notifications and works with Examiners to resolve immediately.
- Monitor File Rejection and File Collaboration ratio
- Constantly evaluate processes, procedures, and team members to ensure efficient operations.
- Reviews claim files for quality across all clients.
- Is responsible for developing and maintaining file standard expertise for all existing Eberl clients and any new clients.
- Adjuster/Examiner Orientation and Training:
- Assist QA Manager with creating and maintaining Client Specific File Examiner and Adjuster Orientations and Job Aides.
- Maintain Document Library of all client specific documentation regarding file requirements, adjuster guidelines, coverage requirements, Client Specific Best Practices, Guidelines and procedures.
- Train New File Examiners.
- Register Examiners and Adjusters for appropriate training courses at the onset of an assignment.
- Ensure that new adjusters have completed orientation training courses
- Disseminate Client Specific information to Examiners and Adjusters at the beginning of a deployment and provide any relevant updates throughout the year.
- Train Examiners on the Eberl Invoicing System.
- Monitor Adjuster SLA Performance:
- Provide Coaching to adjusters that have been identified by Examiners as needing additional training.
- Review Daily SLA reports
- Create, run, analyze, and manage various reports in XA.
- Activate and De-activate Examiners in XA
- Qualify Adjusters in XA
- Assist Adjusters with General Xactimate Questions
Bachelor's degree in a related field, or demonstrated equivalent knowledge and critical thinking skills, preferred. A minimum of 5 years' experience in property claims handling (field and in-office) and property claims review is required. At a minimum, a resident home state adjuster's license is required with the willingness and ability to secure additional adjuster's licenses as requested. Supervisory and managerial skills preferred, including the ability to accomplish goals through others and manage various projects; thorough skill set in, or ability to quickly master, a variety of office software, including Microsoft Office Suite (especially Word, Excel, and Outlook), Xactimate and Xactware, internet communication tools, and/or comparable systems. Sound written and oral business and customer communication skills, including sensitivity to confidential and complex information; basic mathematical skills and fundamental accounting skills to understand company financial data; diplomacy; fine and gross motor skills, as well as mental requirements, to operate of standard office equipment; initiative; problem-solving; critical thinking and abstract thinking; time management, prioritization, and organizing skills; excellent interpersonal, customer service, and problem-solving skills; teamwork, compassion, and respect toward others in keeping with the EM Way, as well as integrity, accountability and adherence to standards of ethical behavior and professional conduct, open and honest communication, and a commitment to continuous improvement and professional development; ability to apply practical continuous improvement methods to accomplish operations goals; fundamental teaching and training skills.
THE ENGLE MARTIN WAY: TOGETHER, IMPACTING LIVES AND SERVING WITH PASSION.
Engle Martin & Associates is dedicated to providing a culture of care, compassion, and respect among its employees, clients, and business partners. We recognize and celebrate the value of our employees’ contributions through initiatives such as the peer-nominated EMpact award and development of The EM Way. We also believe that it is critical to invest in the personal and professional development of our employees; therefore, we provide training opportunities through Engle Martin University, encourage industry association involvement, and support professional designations and certifications. Additionally, Engle Martin is committed to the continuous improvement of processes and procedures through activities such as Kaizen events featuring cross-functional team representatives.
Engle Martin recognizes, too, that it’s our responsibility to be a good corporate citizen, not only inside our organization but also within the community. Our company applauds community outreach across the country through our local EMbrace teams and promotes giving back to our communities through corporate charitable donation and employee donation match programs.