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Claims Examiner I

Work from home Full-time role Hiring

Job Description:

  • Conduct initial intake and review of affirmative claims cases and related documentation
  • Request and obtain police reports, accident reports, medical records, insurance information, and other supporting documentation
  • Identify potential insurance carriers and gather information necessary to support claim development
  • Communicate professionally with claimants, insurance representatives, medical providers, attorneys, and government personnel
  • Perform basic legal and insurance research utilizing available resources such as LexisNexis, Westlaw, and public databases
  • Draft initial Notices of Claim, standard demand letters, and routine correspondence for supervisory review
  • Maintain accurate electronic case files within the Affirmative Claims Management Program (ACMP) or similar claims management systems

Requirements:

  • Associate's Degree or Bachelor's Degree preferred
  • Minimum of 1-3 years of professional experience in claims processing, insurance operations, legal support, customer service, case management, or related fields
  • Excellent written and verbal communication skills
  • Strong customer service and interpersonal communication skills
  • Strong organizational skills and attention to detail
  • Proficiency with Microsoft Office Suite (Word, Excel, Outlook, and Teams)

Benefits:

  • Health insurance
  • 401(k) matching
  • Paid time off
  • Professional development
  • Remote work options

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