Disability Claims Examiner jobs in New Jersey
Disability Claims Examiner reviews, evaluates and processes disability insurance claims according to procedure and practice. Examines claims material to ensure insurance coverage and validity. Being a Disability Claims Examiner has contact with agents, claimants, and policy holders. Typically requires a bachelor's degree or its equivalent. Additionally, Disability Claims Examiner typically reports to a supervisor/manager. To be a Disability Claims Examiner typically requires 0-2 years of related experience. Works on projects/matters of limited complexity in a support role. Work is closely managed. (Copyright 2024 Salary.com)
Recently Added Disability Claims Examiner jobs
Claims Examiner
- Sedgwick Claims Management Services Inc.
-
Marlton, NJ
OTHER
- Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for your mental, physical, financial and professional needs. It means sharpening your skills and growing your career. And it means working in an environment that celebrates diversity and is fair and inclusive. A career at Sedgwick is where passion meets purpose to make a positive impact on the world through the people and organizations we serve. If you are someone who is driven to make a difference, who enjoys a challenge and above all, if you’re someone who cares, there’s a place for you here. Join us and contribute to Sedgwick being a great place to work. Great Place to Work® Most Loved Workplace® Forbes Best-in-State Employer Claims Examiner PRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. ESSENTIAL FUNCTIONS and RESPONSIBILITIES Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Negotiates settlement of claims within designated authority. Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. Prepares necessary state fillings within statutory limits. Manages the litigation process; ensures timely and cost effective claims resolution. Coordinates vendor referrals for additional investigation and/or litigation management. Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner. Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. Ensures claim files are properly documented and claims coding is correct. Refers cases as appropriate to supervisor and management. ADDITIONAL FUNCTIONS and RESPONSIBILITIES Performs other duties as assigned. Supports the organization's quality program(s). Travels as required. QUALIFICATION Education & Licensing Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Experience Five (5) years of claims management experience or equivalent combination of education and experience required. Skills & Knowledge Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business. Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Excellent negotiation skills Ability to work in a team environment Ability to meet or exceed Service Expectations WORK ENVIRONMENT When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking NOTE: Credit security clearance, confirmed via a background credit check, is required for this position. The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. As required by law, Sedgwick provides a reasonable range of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the range of starting pay for this role is 66K-92K. A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. Sedgwick is an Equal Opportunity Employer and a Drug-Free Workplace. If you're excited about this role but your experience doesn't align perfectly with every qualification in the job description, consider applying for it anyway! Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience. You may be just the right candidate for this or other roles. Taking care of people is at the heart of everything we do. Caring counts Sedgwick is a leading global provider of technology-enabled risk, benefits and integrated business solutions. Every day, in every time zone, the most well-known and respected organizations place their trust in us to help their employees regain health and productivity, guide their consumers through the claims process, protect their brand and minimize business interruptions. Our more than 30,000 colleagues across 80 countries embrace our shared purpose and values as they demonstrate what it means to work for an organization committed to doing the right thing – one where caring counts. Watch this video to learn more about us.
- Just Posted
Associate Disability Claims Examiner (Bilingual Preferred)
- Prudential Ins Co of America
-
Virtual Office, NJ
FULL_TIME
- Job Classification: Operations - Insurance Operations Prudential is a company of smart, ambitious professionals working together across a multitude of disciplines. Together, we are building a better f...
- 2 Months Ago
Claims Examiner
- Berkley Environmental
-
Jersey, NJ
FULL_TIME
- W. R. Berkley Corporation, founded in 1967, is one of the nation’s premier commercial lines property casualty insurance providers. Founded in 2004, Berkley Environmental has underwriting and account e...
- 23 Days Ago
Disability Claims Specialist, Complaint Resolution
- Prudential
-
Newark, NJ
FULL_TIME
- Job Classification: Operations - Insurance Operations At Prudential, we believe talent is key to achieving our vision. When you join Prudential, you’ll unlock a motivating and impactful career – all w...
- Just Posted
Claims Examiner - WC
- Berkley
-
Jersey, NJ
OTHER
- Company Details W. R. Berkley Corporation, founded in 1967, is one of the nation’s premier commercial lines property casualty insurance providers. Founded in 2004, Berkley Environmental has underwriti...
- 6 Days Ago
Warranty Claims Examiner
- gafsgi
-
Parsippany, NJ
FULL_TIME
- Job Description: At GAF Commercial we cover more than buildings. We cover each other. No matter what role, tenure, or department, under this roof you are helping to build the market leader in commerci...
- 7 Days Ago
Disability Claims Examiner jobs at Popular Companies
Workers Compensation Claims Analyst
- World Insurance Associates LLC
-
Syosset, NY
- Summary World Insurance Associates is a unique insurance organization offering top products and services from major prov...
- 6/2/2024 12:00:00 AM
Licensed Clinical Psychologist
- Loyal Source Government Services
-
Anchorage, AK
- Give Back to Those that Gave to Us We offer part-time and full-time positions with excellent benefits – opportunities fo...
- 6/2/2024 12:00:00 AM
Psychologist
- Loyal Source Government Services
-
Spokane, WA
- Give Back to Those that Gave to Us We offer part-time and full-time positions with excellent benefits – opportunities fo...
- 6/2/2024 12:00:00 AM
Audiologist
- Veterans Evaluation Services
-
- As an Audiology examiner you will conducting audiology exams and completing applicable disability benefits questionnaire...
- 6/2/2024 12:00:00 AM
Audiologist
- Veterans Evaluation Services
-
- As an Audiology examiner you will conducting audiology exams and completing applicable disability benefits questionnaire...
- 6/2/2024 12:00:00 AM
Optometrist
- Veterans Evaluation Services
-
- Veterans Evaluation Services is seeking qualified Ophthalmologists and Optometrists to join our provider network as an i...
- 6/2/2024 12:00:00 AM
Audiologist
- Loyal Source Government Services
-
- Summary The audiologist performs Medical Disability Examinations (MDE) for veterans when they file disability claims for...
- 6/2/2024 12:00:00 AM
Stable & Mature LTD Claims Examiner
- Matrix Absence Management
-
South Portland, ME
- Job Responsibilities and Requirements The Stable and Mature LTD Claim Examiner will manage an assigned caseload of Long ...
- 5/30/2024 12:00:00 AM
About New Jersey
New Jersey is bordered on the north and northeast by New York (parts of which are across the Hudson River, Upper New York Bay, the Kill Van Kull, Newark Bay, and the Arthur Kill); on the east by the Atlantic Ocean; on the southwest by Delaware across Delaware Bay; and on the west by Pennsylvania across the Delaware River.
New Jersey is often broadly divided into three geographic regions: North Jersey, Central Jersey, and South Jersey. Some New Jersey residents do not consider Central Jersey a region in its own right, but others believe it is a separate geographic and cultural area from the Nor...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Disability Claims Examiner jobs
$54,934 to $68,198