Top Claims Executive plans and directs all aspects of an organization's insurance claims function. Responsible for managing and implementing claims programs for all lines of insurance. Being a Top Claims Executive directs the review and settlement of complex or high dollar claims. Develops procedures and policies to enhance and improve the processing, investigation, and settlement of claims. Additionally, Top Claims Executive ensures legal examinations are made when appropriate. Requires a bachelor's degree. Typically reports to top management. The Top Claims Executive manages a departmental function within a broader corporate function. Develops major goals to support broad functional objectives. Approves policies developed within various sub-functions and departments. Comprehensive knowledge of the overall departmental function. To be a Top Claims Executive typically requires 8+ years of managerial experience. (Copyright 2024 Salary.com)
Atlas Claims Investigation is looking for an experienced Workers' Compensation Investigator to conduct AOE/COE investigations in the Northern California region on a part time basis.
Part Time W2 or 1099 Subcontractors are welcome!
```Duties```
As a Claims Investigator, you will be responsible for conducting thorough investigations into insurance claims to determine their validity. Your role will involve gathering evidence, interviewing witnesses, and analyzing data to make informed decisions. Your attention to detail and strong analytical skills will be essential in uncovering potential fraud and ensuring accurate claim settlements.
- Conduct investigations into insurance claims to determine their legitimacy
- Collect and analyze data related to the claim, including policy information, medical records, and financial documents
- Interview claimants, witnesses, and other relevant individuals to gather information and statements
- Utilize surveillance techniques and tools to monitor claimants' activities when necessary
- Write detailed reports outlining investigation findings and recommendations
- Collaborate with law enforcement agencies and legal professionals as needed
- Stay up-to-date with industry regulations and best practices in fraud prevention and detection
```Experience```
To be successful in this role, you should have the following qualifications:
- Previous experience in claims investigation or a related field is preferred
- Strong report writing skills with the ability to clearly document investigation findings
- Proficiency in data collection and analysis techniques
- Knowledge of insurance policies, procedures, and regulations
- Familiarity with fraud prevention and detection methods
- Background in law enforcement or criminal justice is a plus
- Excellent communication and interpersonal skills
If you are detail-oriented, possess strong investigative skills, and have a passion for uncovering the truth, we encourage you to apply for this position. Join our team of dedicated professionals committed to maintaining the integrity of our insurance claims process.
Note: This job description is intended to provide a general overview of the position. It is not an exhaustive list of responsibilities, qualifications, or benefits associated with the role.
Job Type: Part-time
Pay: $30.00 - $45.00 per hour
Expected hours: 1 – 15 per week
Benefits:
Schedule:
Travel requirement:
Work Location: In person
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