Medical Only Claims Examiner Location Louisville, KY : WHO WE ARE: Harford Mutual Insurance Group is a growing, dynamic community partner located in Bel Air in Harford County, Maryland, offering a positive, diverse, and inclusive work environment with a rich company culture. We provide commercial property and casualty insurance products and services to a regional market. Founded in 1842 on the principles of mutuality for our business clients, our agents, and our company, we believe in insuring opportunity through mutual success® and invite our employees to continue that tradition with respect, integrity, exemplary service, and personal responsibility.
THE OPPORTUNITY The Medical-Only Examiner works within specific limits and authority on low complexity claim assignments. They confirm coverage, contact the insured to confirm the incident, then collect medical bills and issue payment as quickly as possible. The claims handled by a medical only examiner are on a fast track basis and require limited investigation, with a goal of creating a positive experience for the policyholder and injured worker.
WHAT YOU'LL DO: Receive, review and timely process claims.
Proper claim coverage and file documentation. Enter and update claims in claim management system. Establish and update claim reserves promptly. Provide prompt claim acknowledgement to the policyholder. Contact medical providers promptly and request itemized billing statements and medical records. Resolve claims by issuing prompt payment, or denial of claim. Maintain claim diary and comply with departmental diary procedures. Comply with the Unfair Claims Practice laws in the handling of all claims. Respond to claims status inquiries. Continuing education on insurance and claims matters. Performs other duties or special projects as required or as assigned by a supervisor. WHAT YOU'LL BRING: Four-year college degree; or Associate Degree plus 2 years of commensurate work experience to role. 0 - 3 years of experience in claims AINS or AIC preferred; or willingness to participate in continuing education WHO YOU ARE: Ability to understand and analyze policy coverages Strong collaborating skills, and an ability to work effectively both independently and as part of a team Comfortable in a fast-paced environment; high energy, self-motivated and proactive Excellent communication and interpersonal skills Ability to multitask, and be flexible regarding workload and assignments Ability to exercise judgment Experience with Microsoft Windows, Outlook, and Excel or transferable software packages. Holds and maintains appropriate adjuster licensing and certification(s) in assigned territories and will obtain additional licensing based upon business needs Physical Requirements: The physical demands are minimal and typical of similar jobs in comparable organizations.
Americans with Disabilities Act (ADA): Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job duties of the position.
The statements herein are intended to describe the general nature and level of work being performed by employees, and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of Harford Mutual Visit our Careers Page for more information on our competitive compensation/benefits packages.
