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CLAIMS ADJUSTER

Company: HealthSmart
Location: Charleston
Posted on: March 15, 2019

Job Description:

The Claims Adjuster will directly oversee claim handling and/or processing and issuing claim payments.

ESSENTIAL FUNCTIONS

* Review new claims on designated client accounts and establish a plan of action to achieve favorable claim resolution.

* Make compensability and/or liability determinations on indemnity claims.

* Establish reserves, calculate indemnity benefits, pursue subrogation, report to excess carriers, and discuss strategies with legal counsel.

* Consult with clients to understand their needs and goals.

* Provide status reports to customers and keep Account Executives and Claims Manager informed.

* Advocate, consult and provide advice to clients as appropriate.

* Investigate, evaluate and negotiate resolution of large and/or complex claims in accordance with company guideline and best claims practices..

HealthSmart is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, national origin, disability or protected veteran status. If you'd like more information about your EEO rights as an applicant under the law, please visit : http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf
EOE Minorities/Females/Disability/Veterans; VEVRAA Federal Contractor
If you need reasonable accommodation to complete the on-line application, please contact the Human Resources Department at HR@healthsmart.com

Keywords: HealthSmart, Charleston , CLAIMS ADJUSTER, Other , Charleston, West Virginia

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