Senior Claims Representative
Core
Manage high priority accounts and catastrophic claims, including verification, research, coverage recommendations, and reserve adjustments.
Role type
Senior Claims Representative
Builds
Claim resolutions and coverage determinations for members, injured workers, and agents
Domain
Insurance / Workers Compensation
Deliverable
client delivery
Required skills
claim investigation, reserve evaluation, coverage analysis, stakeholder communication, documentation management, customer service, training/mentoring
Preferred skills
Human Resources background, industry certification
Technologies
Microsoft Office, Excel, IVOS
Responsibilities
Maintain claim inventory, verify and evaluate coverage using discretionary judgment, investigate claims via phone and email, obtain documentation, adjust reserves, conclude claim processing, meet with members and attorneys, provide training to personnel, attend industry conferences
Seniority
Senior, hands-on IC
