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Claims Examiner
Ref No.: 18-30565
Location: Plano, Texas
Position Type:Full Time/Contract
Start Date: 05/03/2018
 
  • Evaluates and analyzes documentation thoroughly to determine claim processing according to policy/certificate provisions and state regulations with limited authority limits
  • Analyzes any additional information/documentation received to determine how to proceed with a review of a claim under supervision and determines methods of obtaining information from alternative sources.
  • Manages the review of a claim and the outside sources used in the review.
  • Thoroughly documents correspondence and conversations
  • Corresponds verbally and in writing with claimants, medical providers, medical examiners, and law enforcement
  • Works closely with manager claims examiner, legal counsel, medical director, claims assistants, and other departments.