1099 File Examiner

STRUCTION SOLUTIONS Ce rôle est en télétravail
Partager :

Struction Solutions is actively looking for Desk Examiners to  properly investigate, evaluate, negotiate, settle and close claims as well as participate in various administrative functions of the Claims Department including functioning as support staff to outside Claims Adjusters.

 

Duties and Responsibilities:

The below duties do not constitute a complete and exclusive list.  Duties are subject to change at managers discretion.

 

·       Review and analyze field adjuster reports, estimates, photographs and associated submitted documentation.

·       Review insurance policies provided by Company from its clients.

·       Confirm that the recommendations of the field adjuster are acceptable under the policy.

·       Identify and follow up on any outstanding items needed to finalize the claim.

·       Identify whether experts are needed and recommend the same as soon as possible.

·       Issue all approved letters without further instruction.

·       Make a recommendation with the submission of the claim to Company (this does not need to be a formal report; email is acceptable).

·       Communicate with insureds, field adjusters and all other interested parties.

·       Provide draft decision letters in a format acceptable to the Company containing recommendations.

·       Properly keep documentation in the associated claims systems.

·       Submit claims as needed to the risk supplier/insurer.

·       Follow up on handling requirements as requested by risk supplier/insurer; and

·       Review, note, and refer each report or insurer response within two (2) business days of receipt, with “business day†meaning a Monday, Tuesday, Wednesday, Thursday, or Friday that is not also a federal legal holiday.

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