Claims Examiner - Auto
Job Description
Duties:
Analyze and process commercial auto transportation claims by reviewing coverage, completing investigations, determining liability and evaluating the scope of damages.
Processes commercial auto bodily injury claims and ensures claim files are properly documented and coded correctly.
Responsible for litigation process on litigated claims.
Develops and maintains action plans to ensure state required contact deadlines are met and to move the file towards prompt and appropriate resolution.
Communicates claim action/processing with insured, client, and agent or broker when appropriate.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES
Performs other duties as assigned.
Supports the organization's quality program(s).
Travels as required.
QUALIFICATIONS
Bachelor's degree from an accredited college or university preferred.
Professional certification as applicable to line of business preferred.
Secure and maintain the State adjusting licenses as required for the position.
5 years of commercial auto claims management experience or equivalent combination of education and experience required to include in-depth knowledge of commercial line auto policies, coverage's, principles, and laws.
In-depth knowledge of commercial line auto policies, coverage's, principles, and laws
Knowledge of medical terminology for claim evaluation and Medicare compliance
Knowledge of appropriate application for deductibles, sub-limits, SIR's, carrier and large deductible programs.
Strong oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Strong organizational skills
Strong interpersonal skills
Good negotiation skills
Ability to work in a team environment
Ability to meet or exceed Service Expectations
Must have commercial auto litigation experience, preferably in commercial trucking handling high severity/high value (in excess of (USD)1 million) losses.
This is for bodily injury. Please do not send folks with PD experience only.
TPA experience a plus.
Bodily injury handling experience to include demonstrable mid to high level injury handling.
(USD) threshold handling up to 1 million.
Licensed in the contiguous 48 states.
Litigation handling experience pertaining to BI
Experience working in a fast paced environment, participating in and presenting cases to both internal and external stakeholders.
Benefits:
Healthcare Insurance: Synectics offers eligible employees and their dependents healthcare coverage through BlueCross BlueShield of Illinois. Eligibility begins on the 1st day of the calendar month following 60 days of continuous full time employment with Synectics. Premiums are subsidized by Synectics.
Dental Insurance: Synectics offers eligible employees and their dependents a dental plan through MetLife. Eligibility begins on the 1st day of the calendar month following 60 days of continuous full time employment with Synectics.
Vision Insurance: Synectics offers eligible employees vision insurance through VSP. Eligibility begins on the 1st day of the calendar month following 60 days of continuous full time employment with Synectics.
401(k) Plan: The Synectics Inc. Investment Savings Retirement Plan. Synectics offers all employees who are 21 years of age or older the opportunity to invest in the 401(k) Plan on the first of the month following at least 1 calendar year after employment begins.
Synectics is an equal opportunity employer.
Synectics is a leading staffing and workforce solutions company dedicated to connecting exceptional talent with top organizations. We specialize in IT, engineering, finance, healthcare, and professional services recruitment, offering both contract and permanent staffing solutions. With a people-first approach, we focus on understanding the unique needs of our clients and candidates to create long-term, successful matches. Our mission is to empower businesses with the right talent while helping professionals achieve rewarding career opportunities
