Claims Examiner II
HCC Insurance Holdings, Inc. - Indianapolis, IN

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Position Summary: Under supervision, resolves claims by investigating losses through the collecting and analyzing of data according to policy application and client/underwriter guidelines.

Relying on limited experience and knowledge, the Claims Examiner II is responsible for accomplishing the following assignments. These assignments are varied in nature and frequently non-routine.
  • Determines Insurance coverage by examining claim information, policies and other records, interviews claimants and other providers.
  • Maintains accurate system by collecting, analyzing and summarizing information.
  • Resolves questionable claims by investigation: comparing claims information with evidence.
  • Settles claims by determining insurance carriers liability, reaching agreement with claimant according to policy provisions.
  • Coordinates benefits with other insurance carriers when possible to minimize loss ratios for the client and the company
  • Contributes to Phone support by prompt and accurate answering.
  • Records/updates claims volume and activity in a bordereau for reporting as required by the client, director, or accounting department
  • Maintains Insurance Product and Company reputation by complying with claims guidelines and unfair claims settlement limitations.
  • Maintains Professional and technical knowledge by attending educational workshops such as Covey 7 Habits, establish professional networks.
  • Performs special projects as required
  • Contributes to the team effort by accomplishing related tasks as needed.

Planning
  • Follow work plans, established timelines, and pre-defined goals for assigned work.
  • Meet commitments on deadlines.

Communication
  • Develop strong customer focus and high service level relationship with clients.

Cost Management
  • Perform work thoroughly in a cost efficient manner and at a high productivity level.
  • Utilize company resources effectively.

Business Controls and Policies
  • Comply with all corporate policies and procedures.
  • Take all reasonable steps to safeguard company assets against waste, loss, unauthorized use and misappropriation.
  • Report any breakdown in controls to a Supervisor or Manager.

People Management
  • No people management responsibility
  • May assist in orienting and training less experienced employees.

Requirements

Education
  • High school diploma or equivalent

Experience
  • Minimum of two years of relevant and progressive medical, claims or insurance experience in area of specialization

Other
  • Possess and have ability to apply basic knowledge of principles, practices, and procedures
  • Good written and verbal communication skills with an emphasis on confidentiality, tact, and diplomacy
  • Good organizational and analytical skills; demonstrated ability to manage multiple tasks simultaneously
  • Intermediate proficiency and experience using Microsoft Office Package (Excel, Access, PowerPoint, Word)
  • Superlative customer service skills
  • Basic calculator knowledge.
  • Ability to multi task

About this company
HCC Insurance Holdings, Inc. is a leading specialty insurer with offices in the United States, the United Kingdom, Spain and Ireland,...