Claims Examiner, Sr. jobs in Louisville, KY

Claims Examiner, Sr. reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner, Sr. 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, Sr. determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner, Sr. occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Claims Examiner, Sr. typically requires 2 -4 years of related experience. (Copyright 2024 Salary.com)

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Sr. Claims Examiner
  • Harford Mutual Insurance Group
  • Louisville, KY OTHER
  • Job Details

    Level:    Experienced
    Job Location:    MID West Location - Louisville, KY
    Position Type:    Full Time
    Education Level:    4 Year Degree
    Salary Range:    Undisclosed
    Travel Percentage:    Up to 25%

    WHO WE ARE:

    Harford Mutual Insurance Group is a growing, dynamic community partner located in Bel Air in Harford County, Maryland, offering a positive, diverse, and inclusive work environment with a rich company culture. We provide commercial property and casualty insurance products and services to a regional market. Founded in 1842 on the principles of mutuality for our business clients, our agents, and our company, we believe in insuring opportunity through mutual success® and invite our employees to continue that tradition with respect, integrity, exemplary service, and personal responsibility.

     

    THE OPPORTUNITY

    The Senior Claims Examiner investigates, evaluates, and resolves commercial lines claims and makes recommendations for resolutions from any of Harford Mutual Insurance Group companies.  The incumbent will be expected to handle efficiently and competently medium to high severity claims, and to possess comprehensive knowledge of all coverages and claims handling procedures while providing quality claims service to policyholders and agents. 

     

    WHAT YOU’LL DO: 

    • Conducts prompt and thorough investigations of commercial line claims within departmental and regulatory guidelines through telephone, written, and other communication methods with policyholders, claimants, attorneys, public adjusters, witnesses, and others with pertinent information.
    • Provides quality claims service to our policyholders and agents by remaining in constant communication with them throughout the claim lifecycle.
    • Evaluates coverage, determines liability, utilizes negotiation skills to resolves claims within authority to include ability to draft the respective communications required on the claim.
    • Analyze information to evaluate assigned claims to determine the extent of loss, taking into consideration coverage, damages, liability, and future investigation needs. Assign and manage independent adjusters, defense counsel, or other experts on a task assignment basis where necessary.
    • Demonstrate in-depth understanding of commercial lines coverage issues, policy forms, contracts, regulatory requirements, and changing legal landscape.     
    • Accurately apply the HMIG reserving practice by continually evaluating claim exposure to establish appropriate and timely reserves over the life of the claim and notify claim management when exposure exceeds authority.
    • Establish and execute appropriate action plans to manage claims proactively and promptly with a strategic plan for optimal claim outcomes.  
    • Maintain a claim diary and comply with departmental diary procedures.
    • Excellent organization and problem-solving skills along with the ability to multi-task and prioritize to ensure that all claims are handled efficiently and effectively.
    • Direct and handle subrogation, salvage, and loss recovery efforts on assigned files
    • Continuing education on insurance and claims matters.
    • Performs other duties or special projects as required or as assigned by a supervisor.

     

    WHAT YOU’LL BRING:

    • 3-4 bullet points on from essential duties and responsibilities from old template
    • Four-year college degree; or comparable claims work experience
    • Over 5 years’ experience in progressive claims roles
    • AIC or similar designation

     

    WHO YOU ARE: 

    • Ability to understand and analyze policy coverages
    • Ability to analyze information to virtually estimate damages
    • Strong negotiation skills
    • Strong collaborating skills, and an ability to work effectively both independently and as part of a team
    • Comfortable in a fast-paced environment with frequent deadlines; high energy, self-motivated and proactive
    • Excellent communication and interpersonal skills to convey complex data and information to audiences with varying levels of expertise
    • Ability to multitask, and be flexible regarding workload and assignments
    • Ability to exercise judgment
    • Strong organizational skills and time management of claims desk
    • Maintain valid adjusters’ license(s) in states assigned or an ability to obtain same.                                                                                              

     

     

    Visit our Careers Page for more information on our competitive compensation/benefits packages.

     


  • 16 Days Ago

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Remote Claims Examiner
  • Firstsource
  • Louisville, KY FULL_TIME
  • Responsibilities: - Review and analyze medical claims to determine coverage and eligibility - Investigate and gather information to support claim decisions - Evaluate medical records, bills, and other...
  • 24 Days Ago

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KY - 1099 Property Claims Adjuster
  • Copper Claims Services, Inc.
  • Louisville, KY CONTRACTOR,PART_TIME
  • 1099 Property Claims AdjusterCopper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA.Copper Claims Services excels in providing custom claims solutions for ...
  • 15 Days Ago

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Claims- Field Claims Representative
  • The Cincinnati Insurance Companies
  • Louisville, KY FULL_TIME
  • US-KY-Louisville Description Make a difference with a career in insurance At The Cincinnati Insurance Companies, we put people first and apply the Golden Rule to our daily operations. To put this into...
  • 16 Days Ago

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Mobile Phlebotomist / Examiner (C)
  • APPS ParamedicalServices
  • Bowling Green, KY CONTRACTOR
  • APPS Paramedical Services is looking for independent contractors/mobile phlebotomists.We do examinations for leading life insurance companies as well as clinical businessStrong phlebotomy skills are r...
  • 16 Days Ago

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Mobile Phlebotomist / Examiner (C)
  • APPS Paramedical Services
  • Bowling Green, KY CONTRACTOR
  • APPS Paramedical Services is looking for independent contractors/mobile phlebotomists.We do examinations for leading life insurance companies as well as clinical businessStrong phlebotomy skills are r...
  • 16 Days Ago

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0 Claims Examiner, Sr. jobs found in Louisville, KY area

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Police Officer
  • Department of Defense
  • Louisville, KY
  • Summary You will serve as a Police Officer (Instructor) for the DEPARTMENT OF THE NAVY. Learn more about this agency Hel...
  • 4/22/2024 12:00:00 AM

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Business Intelligence Lead - Medicaid
  • Humana
  • Louisville, KY
  • Become a part of our caring community and help us put health first The population health analytics team within Humana is...
  • 4/22/2024 12:00:00 AM

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Pharmacy Claims Lead - Financial Recovery
  • Humana
  • Louisville, KY
  • Become a part of our caring community and help us put health first The Pharmacy Claims Lead - Financial Recovery leads a...
  • 4/21/2024 12:00:00 AM

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Lead Software Engineer
  • Humana
  • Louisville, KY
  • Become a part of our caring community and help us put health first Do you want be part of a team that is continuously le...
  • 4/21/2024 12:00:00 AM

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Value Based Programs Lead
  • Humana
  • Louisville, KY
  • Become a part of our caring community and help us put health first The Value-Based Programs Lead supports successful val...
  • 4/21/2024 12:00:00 AM

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Grievances & Appeals Representative
  • Humana
  • Louisville, KY
  • Become a part of our caring community and help us put health first The G&A rep 3 investigates and resolves grievances an...
  • 4/21/2024 12:00:00 AM

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Claims- Field Claims Representative
  • Cincinnati Insurance Company, Inc.
  • Louisville, KY
  • Description: Make a difference with a career in insurance At The Cincinnati Insurance Companies, we put people first and...
  • 4/20/2024 12:00:00 AM

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Security Officer - Night
  • White Lodging
  • Louisville, KY
  • Summary: The Security Officer will be responsible for promoting a safe environment for guests and associates of the hote...
  • 4/20/2024 12:00:00 AM

Louisville and Jefferson County have a combined area of 397.68 square miles (1,030.0 km2), of which 380.46 square miles (985.4 km2) is land and 17.23 square miles (44.6 km2) (4.33%) is covered by water. Louisville is southeasterly situated along the border between Kentucky and Indiana, the Ohio River, in north-central Kentucky at the Falls of the Ohio. Although situated in a Southern state, Louisville is influenced by both Southern and Midwestern culture. It is sometimes referred to as either one of the northernmost Southern cities or as one of the southernmost Northern cities in the United St...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner, Sr. jobs
$59,553 to $76,780
Louisville, Kentucky area prices
were up 1.2% from a year ago

Claims Examiner, Sr. in Riverside, CA
Health Claims Examiners, or Health Information Technicians, enter data electronically to process transactions.
December 14, 2019
Claims Examiner, Sr. in Evansville, IN
If you’re in dire straits, we can advise you on steps to get the OWCP claims examiner to pay attention to your needs, such as contacting the Department of Labor’s district director, or the national director via mail.
February 12, 2020
Claims Examiner, Sr. in Springfield, IL
No, the examiner is only involved in performing the exam and providing the results to the claims processor.
January 13, 2020