Claims Examiner jobs in South Carolina

Claims Examiner reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner work is closely managed. Works on projects/matters of limited complexity in a support role. To be a Claims Examiner typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)

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Claims Examiner Specialty Claims
  • USLI
  • Charleston, SC FULL_TIME
  • The ideal claims team member will be an analytical and creative problem solver with the ability to hone in on key issues for coverage, liability and damage evaluation. Our claim examiners are assertive decision makers with a strong desire to persuade through negotiation and conflict management. The claims team offers on going challenges, even for the most experienced professional, as every claim is unique, providing new opportunities to learn and grow. We welcome our ongoing interaction with underwriting, compliance and actuarial to keep our products healthy.

    Essential Functions:

    Coverage is confirmed by reviewing the first notice of loss, checking all available systems, and interpreting policy language. Upon coverage analysis, the examiner prepares initial position letters to the policyholder such as disclaimers and reservation of rights. Once coverage is confirmed, the examiner conducts a thorough and focused investigation of the claim. Investigation includes securing all pertinent facts, statements & documents, identifying joint tortfeasors and witnesses as well as scene investigation. Initial reserves are posted, reviewed and maintained as file develops to properly reflect ultimate exposure based upon liability and damage evaluation. The examiner is responsible for proactive file management toward final disposition via an effective diary, direction to defense counsel & independent adjusters, analysis & strategy leading to negotiated settlement or trial. Substantive file documentation in claim notes should reflect file activity. While the claim is pending, communication includes delivery of comprehensive and concise authority requests, reinsurance reports, serious loss reports, coverage position letters and appropriate communication with underwriting and actuary.

    Other Duties and Responsibilities:

    In addition to the essential functions, an examiner is expected to support customer service by responding the same day to phone and email both internally and externally and adhere to established claim service promises. The position may entail completion of special projects. There is an expectation for enrollment in continuing education to maintain state licenses and to support both professional and personal development as outlined in the annual Individual Development Plan. Some travel is required to attend mediations and/or mandatory court hearings.

    Specific Skills:

    Strong oral and written communication skills, insightful analytical skills, effective negotiation skills, strong organizational and time management skills, technical knowledge of insurance coverage, negligence law and claim evaluation.

    Minimum Job Requirements:

    We are seeking 2 years (Associate Claim Examiner) or 7 years (Claim Examiner) of relevant experience handling general liability/casualty/excess matters including prior examiner, adjuster, paralegal and/or other transferable experience. Excess liability experience, multi-jurisdictional knowledge, advanced degrees and/or JD are a plus.

    At USLI, our goal is to strengthen our community and culture by representing all races, genders, religions and sexual orientations. We continue to move conversations about diversity, equity and inclusion forward to ensure every community member has a sense of belonging, a voice and a seat at the table.

    USLI provides full-time community members with a comprehensive benefits package, access to wellness programs, continuing education resources, and multiple opportunities to get involved with charitable organizations.

    Job Type: Full-time

    Benefits:

    • 401(k)
    • Dental insurance
    • Health insurance
    • Life insurance
    • Paid time off
    • Professional development assistance
    • Referral program
    • Vision insurance

    Schedule:

    • Monday to Friday

    Travel requirement:

    • No travel

    Work setting:

    • In-person
    • Office

    Work Location: In person

  • 19 Days Ago

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Medical Claims Examiner
  • Questpro
  • Greenville, SC FULL_TIME
  • Our TPA client is looking for a medical claims examiner with previous experience in a TPA or medical insurance background and will be responsible for processing medical, dental, vision and Flexible Sp...
  • 5 Days Ago

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Property Claims Examiner
  • Blair & Company
  • , SC FULL_TIME
  • DESCRIPTION: Manages and investigates submitted first party Property insurance claims, directly and/or indirectly through the use of independent adjusters, including Commercial Property, Personal Resi...
  • 5 Days Ago

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Liability Claims Examiner
  • Blair & Company
  • , SC FULL_TIME
  • Our claims department is currently seeking a Liability Claims Examiner to handle commercial liability insurance claims. The ideal candidate for this position will have a background in commercial liabi...
  • 8 Days Ago

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Disability Determination Examiner I (6 Positions) - Office of State Claims (Repost)
  • State of South Carolina
  • Lexington, SC FULL_TIME
  • Join South Carolina state government where you can have a meaningful career, incomparable benefits, and a positive work-life balance!You will, under guidance of a supervisor or designee, reviews appli...
  • 17 Days Ago

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Roof Technician
  • Hancock Claims Consultants
  • Charleston, SC CONTRACTOR
  • CLIMB to New Heights…And live the American Dream. Become part of something bigger by contracting with the nation’s top provider of roof and property inspection services working with insurance carriers...
  • 2 Days Ago

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Claims Examiner
  • Manpower
  • El Segundo, CA
  • Our client, Legal Industry is seeking a Claims Examiner to join their team. As a Legal Claims Examiner you will be part ...
  • 6/11/2024 12:00:00 AM

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Claims Examiner
  • US Tech Solutions, Inc.
  • Atlanta, GA
  • Job Title: Claims Examiner Location: Remote Duration: 06 months contract (C2H) Job Description: Responsibilities: • Inve...
  • 6/11/2024 12:00:00 AM

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Claims Examiner
  • Insight Global
  • Folsom, CA
  • The Claims Examiner is responsible for ensuring claims are coded and processed correctly and for meeting production requ...
  • 6/10/2024 12:00:00 AM

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Claims Examiner
  • Hire Up Staffing Services
  • Fresno, CA
  • Hire UP Staffing is seeking an experienced Medical Claims Examiner for well established client in Fresno, CA. This posit...
  • 6/10/2024 12:00:00 AM

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CLAIMS EXAMINER
  • San Bernardino City Unified
  • San Bernardino, CA
  • Comments and Other Information To review the job description, please use the following link. https://www.schooljobs.com/...
  • 6/10/2024 12:00:00 AM

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Claims Examiner
  • SILAC Insurance Company
  • Salt Lake City, UT
  • Headquartered in Salt Lake City, Utah, SILAC Insurance Company is one of the fastest-growing insurance companies in the ...
  • 6/9/2024 12:00:00 AM

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Claims Examiner
  • E-Solutions
  • Whittier, CA
  • POSITION SUMMARY: The claims examiner reports directly to the claims manager. They are primarily responsible for the pro...
  • 6/8/2024 12:00:00 AM

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Claims Examiner
  • Insight Global
  • Sacramento, CA
  • Day to Day: The Claims Examiner 1 is responsible for ensuring claims are coded and processed correctly and for meeting p...
  • 6/7/2024 12:00:00 AM

South Carolina (/ˌkærəˈlaɪnə/ (listen)) is a state in the Southeastern United States and the easternmost of the Deep South. It is bordered to the north by North Carolina, to the southeast by the Atlantic Ocean, and to the southwest by Georgia across the Savannah River. South Carolina became the eighth state to ratify the U.S. Constitution on May 23, 1788. South Carolina became the first state to vote in favor of secession from the Union on December 20, 1860. After the American Civil War, it was readmitted into the United States on June 25, 1868. South Carolina is the 40th most extensive and 23...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner jobs
$45,409 to $60,215