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)
The New Jersey Hospital Association is a not-for-profit trade organization committed to delivering support and services to the states hospitals, health systems and other healthcare providers. We share a collective goal of providing quality, affordable and accessible healthcare to the people of the Garden State. We are seeking a Claims Manager.
Objective: Reviews routine unemployment insurance claims. Also reviews complex claims with input from senior PCM staff. In disputed claims conducts investigation and with input from senior staff determines if appeal is warranted and follows through on appeals process.
Essential Job Functions:
Non-Essential Job Functions:
Qualifications: High school graduate. Good communication skills. Individual should not pose a threat to the health or safety of self or others.
NJHA offers a competitive salary and a comprehensive benefits package including no-deductible medical insurance, dental, flexible spending accounts, 401(k) with employer match, pension plan, (state) short term disability, long term disability, life, employee assistance program, credit union, and generous paid vacation, holiday, and personal, and sick days.
In compliance with the ADA Amendments Act (ADAAA), should you have a disability and would like to request an accommodation in order to apply for a currently open position with NJHA, please call 609-275-4004.
Equal Opportunity Employer/Veterans/Disabled
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0 Claims Examiner jobs found in Trenton, NJ area