Claims Examiner, Sr. jobs in Washington

Claims Examiner, Sr. reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner, Sr. studies reports prepared by adjusters and similar claims to determine the extent of insurance coverage and validity of the claim. Communicates with agents, claimants, and policy holders. Additionally, Claims Examiner, Sr. determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner, Sr. occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Claims Examiner, Sr. typically requires 2 -4 years of related experience. (Copyright 2024 Salary.com)

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Claims Examiner Trainee
  • WPAS
  • Mercer Island, WA FULL_TIME
  • Responsibilities:

    • Work with trainer and/or assigned co-worker to learn and perform review of plan documents and procedures to apply plan provisions, limitations and exclusions when making benefit determinations.
    • Learn to request information to complete or review claims using standard procedures and letters, and asks questions as needed.
    • Must demonstrate ability to learn and grow with continuous improvement and ability to increase average daily claim production while maintaining accuracy and quality.
    • Performs computations and processes claims independently up to the dollar threshold set by thetrainer not to exceed the job classification maximum of $1,500.00.
    • Learns to perform duties and prepare to become a Claims Examiner by meeting training objectives and expected production metrics.
    • Communicates efficiently by telephone, in writing or in person with all personnel, members, providers, external vendors or others regarding claim benefit questions or information.
    • Communicates with the Quality Assurance Supervisor in conjunction with their trainer as necessary to request and receive data on pending claims.
    • Learns to apply procedures to third-party liability claim claims.
    • Exercises professional judgment on daily tasks and seeks approval from supervisor or trainer when faced with new or unfamiliar tasks.
    • Maintain a 10 business-day turnaround time on assigned claim responsibilities.
    • Maintain and update a pending file with follow-ups on correspondence as required.
    • Ability to meet production and quality goals on a consistent basis as outlined within training.
    • Routes claims requiring review to the assigned Claim Adjuster Senior II.
    • Demonstrates knowledge of assigned duties as well as the legacy and the recently migrated claims processing system.
    • Perform other duties as assigned.
    • Minimum qualifications:

    Minimum qualifications:

    • 6 months or more within a Claims Pre-Processor position Or
    • 6 months in another position with field related experience.
    • Working knowledge of basic office equipment.
    • Positive interpersonal communications with internal personnel, external clients and vendors.
    • Demonstrated ability to keep calm and positive within all communications.
    • Proven ability to accurately and timely review and edit documents.
    • Utilize computer, phone systems and reference materials to be able to effectively perform the essential functions of the position.
    • Previous experience utilizing Microsoft office software.
    • High school diploma or G.E.D

    Job Type: Full-time

    Pay: $21.43 - $23.53 per hour

    Expected hours: 37.5 per week

    Benefits:

    • 401(k)
    • Dental insurance
    • Health insurance
    • Life insurance
    • Paid time off
    • Referral program
    • Vision insurance

    Schedule:

    • Monday to Friday

    Travel requirement:

    • No travel

    Work setting:

    • In-person
    • Office

    Work Location: In person

  • 23 Days Ago

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Examiner
  • Federal Housing Finance Agency (FHFA)
  • Seattle, WA FULL_TIME
  • Summary Scroll down for a complete overview of what this job will require Are you the right candidate for this opportunity We have openings for entry-level examiners in the Division of Federal Home Lo...
  • 21 Days Ago

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Sr Actuary, Global Risk Management & Claims
  • Amazon
  • WA, WA FULL_TIME
  • DESCRIPTIONWe are expanding our Global Risk Management & Claims team and insurance program support for Amazon’s growing risk portfolio. This role will partner with our risk managers to develop pricing...
  • 3 Days Ago

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WA - Spokane - 1099 Property Adjuster
  • Copper Claims Services, Inc.
  • Spokane, WA CONTRACTOR
  • 1099 Property Adjuster Copper Claims Services is a quickly growing independent loss adjusting firm based out of Irvine, CA. Copper Claims Services excels in providing custom claims solutions for Prope...
  • 21 Days Ago

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Balance Verification Clerk
  • Claims Management Inc
  • Puyallup, WA FULL_TIME
  • Job Description Job Description Please read entirely before applying. Vaccination status is not a consideration for employment Claims Management Incorporated is a company that provides paralegal servi...
  • Just Posted

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Entry-level Paralegal - Now Hiring
  • Claims Management Inc
  • Puyallup, WA FULL_TIME
  • Job DescriptionCMI exists to improve the world by championing the injured. We are a rapidly growing firm looking for amazing team members, which in this case, is a skilled and compassionate paralegal....
  • 1 Day Ago

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Cargo Claims Examiner
  • Swift Transportation
  • Phoenix, AZ
  • Description Position at Swift Transportation Accelerate your Career! At Swift, our greatest asset is OUR PEOPLE! We stri...
  • 3/29/2024 12:00:00 AM

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Claims Examiner I
  • Western Growers Family of Companies
  • Irvine, CA
  • Description Part of the Western Growers Family of Companies, Western Growers Assurance Trust (WGAT) was founded in 1957 ...
  • 3/29/2024 12:00:00 AM

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Senior California Workers' Compensation Claims Examiner | Remote
  • KING'S INSURANCE STAFFING LLC
  • Los Angeles, CA
  • Our client, an A Rated Insurance Carrier, is seeking to add a Remote - Senior California Workers' Compensation Claims Ex...
  • 3/29/2024 12:00:00 AM

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Claims Investigator (Syracuse, NY Region)
  • Gallagher Bassett
  • Syracuse, NY
  • Gallagher Bassett is the premier provider of global claims, loss control, and risk management consulting services, dedic...
  • 3/28/2024 12:00:00 AM

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Claims Investigator (Buffalo, NY Region)
  • Gallagher Bassett
  • Buffalo, NY
  • Gallagher Bassett is the premier provider of global claims, loss control, and risk management consulting services, dedic...
  • 3/28/2024 12:00:00 AM

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Claims Investigation Analyst I, Geisinger Health Plan (work from home Pennsylvania)
  • Geisinger Health
  • Danville, PA
  • Location: Work from home (Pennsylvania) Shift: Days (United States of America) Scheduled Weekly Hours: 40 Worker Type: R...
  • 3/28/2024 12:00:00 AM

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Transportation Claims Examiner
  • Swift Transportation Company
  • Phoenix, AZ
  • **Description** *Position at Swift Transportation* *****REMOTE or Local Opportunity*** Accelerate your Career!** At Swif...
  • 3/27/2024 12:00:00 AM

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Claims Investigator
  • Claims Management Inc
  • Puyallup, WA
  • Job Description Job Description CMI exists to improve the world by championing the injured. We are a rapidly growing fir...
  • 3/25/2024 12:00:00 AM

Washington (/ˈwɒʃɪŋtən/), officially the State of Washington, is a state in the Pacific Northwest region of the United States. Washington is the northwestern-most state of the contiguous United States. It borders Idaho to the east, bounded mostly by the meridian running north from the confluence of the Snake River and Clearwater River (about 116°57' west), except for the southernmost section where the border follows the Snake River. Oregon is to the south, with the Columbia River forming the western part and the 46th parallel forming the eastern part of the Oregon-Washington border. To the wes...
Source: Wikipedia (as of 04/17/2019). Read more from Wikipedia
Income Estimation for Claims Examiner, Sr. jobs
$66,644 to $85,920

Claims Examiner, Sr. in Sarasota, FL
After reading this, you will have a much better idea on whether you will like working as a Property and Casualty Insurance Claims Examiner or not.
January 17, 2020
Claims Examiner, Sr. in Fairbanks, AK
Still, a good number of students health claims specialist resume have to contend with language skill barriers.
February 05, 2020
Claims Examiner, Sr. in Idaho Falls, ID
Kevin Pitts joined CIRSA a little over a year ago as a Workers’ Compensation Claims Examiner.
December 18, 2019