Senior Medical Only Claims Representative

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Oversee a portfolio of claims to assess compensability and liability.

• Plan and execute investigations into claims to verify coverage and establish liability, compensability, and damages.

• Identify and negotiate suitable claim settlements and reserves within designated authority.

• Participate in arbitrations, mediations, depositions, or trials as required.

• Communicate moderately complex information regarding coverage and settlements to insureds, claimants, and external stakeholders.

• Approve payments within assigned authority limits and ensure they are processed promptly.

• Maintain precise and comprehensive claim files, which include correspondence, reports, and settlement agreements.

• Manage Medical Only claims.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• Bachelor’s Degree in Business Administration, Risk Management and Insurance, Finance, or a related field, or equivalent experience.

• Typically, a minimum of 5 years of experience in property and casualty claims management.

• Completion of or ongoing progress towards a professional designation is preferred, such as Associate in Claims (AIC).

• Strong analytical, negotiation, and problem-solving abilities.

• Familiarity with insurance policies, coverage, and claims handling processes.

• Understanding of industry laws and regulations.

• Capability to organize and prioritize caseloads, ensuring prompt resolution of claims.

• Exceptional interpersonal and communication skills.

• Ability to cultivate relationships and lead negotiations effectively.

• Proven track record of handling confidential information with discretion.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Wellness plans.

• Parental leave.

• Adoption assistance.

• Tuition reimbursement.

• Paid Time Off.

• Paid holidays.

• 401(k) plan with company match.

• Employee stock purchase plan.

• Commuter benefits.