Claims Examiner jobs in Oregon
Claims Examiner reviews, evaluates, and processes insurance claims and makes recommendations for resolution. Examines and authorizes insurance claims investigated by insurance adjusters. Being a Claims Examiner 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 determines settlement according to organization practices and procedures. May require a bachelor's degree. Typically reports to a supervisor or manager. The Claims Examiner work is closely managed. Works on projects/matters of limited complexity in a support role. To be a Claims Examiner typically requires 0-2 years of related experience. (Copyright 2024 Salary.com)
Recently Added Claims Examiner jobs
Claims Examiner I
- TRISTAR Insurance Group
-
Oswego, OR
FULL_TIME
-
POSITION SUMMARY: Under close supervision manages all aspects of Medical Only claims handling from inception to conclusion within established authority and guidelines.
This position requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other TRISTAR staff in the office; therefore consistently being at work in the office or home office location as applicable, in a timely manner, is inherently required of this position.
Duties And Responsibilities- Effectively manages a caseload of 150 to 200 workers’ compensation files.*
- Initiates and conducts claims investigation in a timely manner.*
- Medical only, indemnity.
- Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.*
- Manages medical treatment and medical billing, authorizing as appropriate, with requests for surgical treatment to be referred to supervisor prior to authorizing. *
- Communicates with claimants, providers and vendors regarding claims issues.*
- Computes and set reserves within Company guidelines, up to $10,000. *
- Finalizes all claims and obtains authority as designated.*
- Maintains diary system for case review and document file to reflect the status of and work being performed on the file.*
- Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns.*
- Involves designated loss control staff when appropriate.*
- Adheres to all Company policies and procedures.*
- Participates in file reviews, as needed.
- Other duties as assigned to include assisting as a claims assistant.
- Essential job function.
SPECIAL EQUIPMENT OR CLOTHING: Appropriate office attire
Qualifications Required
Education/Experience: Bachelor’s degree in related field (preferred); and one (1) year related experience; or equivalent combination of education and experience.
Knowledge, Skills And Abilities- Technical knowledge of statutory regulations and medical terminology.
- Analytical skills.
- Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff.
- Ability to interact with persons at all levels in the business environment.
- Proficient in Word and Excel (preferred).
- Certification and/or or license in OR and WA or ability to become certified.
- 5 Days Ago
Claims Examiner I
- TRISTAR RISK MANAGEMENT
-
Oswego, OR
FULL_TIME
- POSITION SUMMARY: Under close supervision manages all aspects of Medical Only claims handling from inception to conclusion within established authority and guidelines. This position requires considera...
- 16 Days Ago
Claims Examiner I
- Tristar Insurance
-
Oswego, OR
OTHER
- Job Details Level: Experienced Job Location: Portland - Lake Oswego, OR Position Type: Full Time Education Level: High School Diploma or GED Salary Range: $23.00 - $26.00 Hourly Travel Percentage: Neg...
- 17 Days Ago
Workers Compensation Claims Examiner II
- TRISTAR Insurance Group
-
Oswego, OR
FULL_TIME
- IN OFFICE POSITION- Oregon Washington certification or ability to become certifiedPlease sign the application at the endPOSITION SUMMARY: Under minimal supervision, manages all aspects of indemnity cl...
- 5 Days Ago
Workers Compensation Claims Examiner II
- Tristar Insurance
-
Oswego, OR
OTHER
- Job Details Level: Experienced Job Location: Portland - Lake Oswego, OR Position Type: Full Time Education Level: High School Diploma or GED Salary Range: $62,000.00 - $72,000.00 Salary/year Travel Pe...
- 20 Days Ago
Workers Compensation Claims Examiner II
- TRISTAR RISK MANAGEMENT
-
Oswego, OR
FULL_TIME
- IN OFFICE POSITION- Oregon Washington certification or ability to become certified Please sign the application at the end POSITION SUMMARY: Under minimal supervision, manages all aspects of indemnity ...
- 22 Days Ago
Claims Examiner jobs at Popular Companies
Claims Examiner
- Insight Global
-
Sacramento, CA
- Day to Day: The Claims Examiner 1 is responsible for ensuring claims are coded and processed correctly and for meeting p...
- 6/2/2024 12:00:00 AM
Claims Examiner
- Manpower
-
El Segundo, CA
- Our client, Legal Industry is seeking a Claims Examiner to join their team. As a Legal Claims Examiner you will be part ...
- 6/1/2024 12:00:00 AM
Claims Examiner
- Insight Global
-
Folsom, CA
- The Claims Examiner is responsible for ensuring claims are coded and processed correctly and for meeting production requ...
- 5/31/2024 12:00:00 AM
Claims Examiner
- Fortuna BMC
-
Folsom, CA
- Pay: $20 - $26 per hour Location: Folsom, CA Employment Type: Full-time WHAT WE OFFER: Competitive pay rates based on ex...
- 5/31/2024 12:00:00 AM
Claims Examiner
- AltaMed
-
Montebello, CA
- Work Boldly. Live Brilliantly. At AltaMed, we don't just serve our communities, we are part of them. We have raised the ...
- 5/30/2024 12:00:00 AM
Claims Examiner
- SILAC Insurance Company
-
Salt Lake City, UT
- Headquartered in Salt Lake City, Utah, SILAC Insurance Company is one of the fastest-growing insurance companies in the ...
- 5/30/2024 12:00:00 AM
Claims Examiner
- E-Solutions
-
Whittier, CA
- POSITION SUMMARY: The claims examiner reports directly to the claims manager. They are primarily responsible for the pro...
- 5/29/2024 12:00:00 AM
Claims Examiner
- Erie Insurance
-
Erie, PA
- Division or Field Office: Claims Division Department of Position: Corporate Claims Department Work from: ERIE's Footprin...
- 5/29/2024 12:00:00 AM
About Oregon
Oregon (/ˈɒrɪɡən/ (listen) ORR-ih-gən) is a state in the Pacific Northwest region on the West Coast of the United States. The Columbia River delineates much of Oregon's northern boundary with Washington, while the Snake River delineates much of its eastern boundary with Idaho. The parallel 42° north delineates the southern boundary with California and Nevada. Oregon is one of only four states of the continental United States to have a coastline on the Pacific Ocean.
Oregon was inhabited by many indigenous tribes before Western traders, explorers, and settlers arrived. An autonomous government ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Examiner jobs
$48,872 to $64,808