Claims Adjuster Liability
Company: ICONMA, LLC
Location: Brea
Posted on: January 27, 2023
Job Description:
- To analyze mid- and higher-level general liability claims to
determine benefits due; to ensure ongoing adjudication of claims
within company standards and industry best practices; and to
identify subrogation of claims and negotiate settlements.
- Manages mid-level general liability claims by gathering
information to determine liability exposure; assigns reserve values
to claims, making claims payments as necessary, and settling claims
up to designated authority level.
- Assesses liability and resolves claims within an
evaluation.
- Approves and processes assigned claims, determines benefits
due, and manages action plan pursuant to the claim or client
contract.
- Manages subrogation of claims and negotiates
settlements.
- Communicates claim action with claimant and client.
- Ensures claim files are properly documented and claims coding
is correct.
- May process complex lifetime medical and/or defined period
medical claims which include state and physician filings and
decisions on appropriate treatments recommended by utilization
review.
- Maintains professional client relationships.
- Performs other duties as assigned.
- Supports the organization's quality program(s). -
-
Requirements
- Bachelor's degree from an accredited college or university
preferred.
- Experience Four (4) 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.
-
- When applicable and appropriate, consideration will be given to
reasonable accommodations.
-
Requirements:
- 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.
- Computer keyboarding.
- Hearing, vision and talking.
- We need somebody with General liability experience, not just
auto.
- Preferably retail or other commercial industries involving
premises claims such as slip and fall, products liability. -
-
- Preferably has their Property/Casualty Adjuster
license.
- No litigation experience is required, so even 5 years'
experience would be considered.
- Bachelor's Degree.
-
As an equal opportunity employer, ICONMA prides itself on creating
an employment environment that supports and encourages the
abilities of all persons regardless of race, color, gender, age,
sexual orientation, citizenship, or disability.
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Keywords: ICONMA, LLC, Fullerton , Claims Adjuster Liability, Other , Brea, California
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