Associate, Claims Examiner
- Career Level
- Not Specified
York Risk Services Group is a premier provider of insurance, risk management, alternative risk, pool administration and claims management solutions to clients across hundreds of industries. Recently named by Forbes as one of "America's Best Midsized Companies 2017" We firmly believe that our employees drive the success of the company. With success in mind as the ultimate goal, we strive to create and provide an environment that offers challenging, stimulating and financially rewarding opportunities.
Under close supervision, investigates claims of lesser value or complexity to determine an injured workers entitlement to Workers Compensation benefits; Administers indemnity and medical benefits for valid Workers Compensation claims; manages a caseload of claims from inception to closing or settlement; Completes formal training program for consideration of advancement to Claims Examiner position.
- Participates in ongoing training sessions, both formal and informal, to include York requirements and state-specific statutory requirements
- Completes 3-point contact on new claims within 24 hours in order to obtain information necessary to make a compensability decision on the claim
- Annotates, categorizes and addresses incoming mail on a daily basis
- Responds to questions and requests from the client
- Ensure claim files are properly documented
- Maintains professional client relationships and provides superior customer service
- Each Examiner Trainee must successfully complete all State mandated continuing education hours and must also obtain the necessary license or certification in accordance with State regulations.
- Evening or weekend courses/seminars might be required in order to meet certification/licensing requirements.
- Ability to prioritize multiple tasks and meet deadlines
- Excellent written and verbal skills
- Excellent customer service skills
- Good interpersonal skills
- Ability to work in a team environment
- Workers Compensation law, policies and procedures preferred
- Medical and legal terminology preferred
- Integration with Medicare preferred
- BS / BA or Equivalent Work Experience
- 0 to 2 years