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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). -

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    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.

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      • When applicable and appropriate, consideration will be given to reasonable accommodations.

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        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.

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          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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