Broadspire

Telephonic Case Manager – RN   (Nationwide)

Coordinates and medically manages a range of health care services to designated clients through telephonic communication with patients, employers, providers, adjusters, and others to determine if treatment is medically necessary, appropriate, and effective, and to secure a timely return to work status for the patient. RN state licensure in good standing with the State Board of Nursing. Minimum of 3-5 years diverse clinical experience or prior experience in Care Management. CCM and/or CRRN with multi-state licensure preferred.  This is a “work from home” position.  

Senior Claims Examiner – Workers Compensation (Nationwide)

Investigates and settle advanced, large loss, complex claims promptly and equitably under minimal supervision. Works within established authority on moderate-to-difficult claims. Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices. Evaluates and sets reserves using independent judgment. Assists supervisor and company attorneys in preparing cases for litigations. Conducts training and mentors new hires.  Technical claims investigations/settling experience with 5-8 years experience in Claims or similar organization.  Industry designations (IIA, AIC, AEI, and/or CPCU) preferred.  

Claims Examiner III – Workers Compensation (Nationwide)

Investigates and settles moderate-to-difficult claims for assigned lines of business promptly and equitably under general supervision. Reviews coverages, determines liability and compensability, secures information, arranges property damage appraisals and settles claims utilizing claims best practices. Sets reserves and recommends reserve changes to supervisor and Company attorneys in preparing cases for litigation.  Bachelor’s degree or equivalent experience required. Worker’s Comp – Technical claims investigations/settling experience with 3-6 years experience. Workers Compensation (WC) Adjuster License according to jurisdictional requirements.  Industry designations (IIA, AIC, AEI, and/or CPCU) preferred.  

Claims Examiner II – Workers Compensation (Nationwide)

Investigates, evaluate, negotiate, and settle moderately difficult type claims; takes appropriate action to achieve results that have a positive impact on profitability. Settle claims for assigned lines of business promptly and equitably under general supervision. Bachelor’s degree or equivalent experience required. Comprehensive claims investigations/settling experience with 1-2 years experience in Claims or similar organization. Workers Compensation (WC) Adjuster License according to jurisdictional requirements.     

Claims Examiner I – Workers Compensation (Nationwide)

Under direct supervision of the Claims Supervisor, manage and resolve non-complex claims, usually those of low monetary amounts and short duration, and make decisions on claims within delegated limited authority. Bachelor’s degree or equivalent experience required. Working knowledge of claims and familiarity with claims terminology gained through equivalent industry experience and/or through specialized courses of study (Associates in Claim designation). Workers Compensation (WC) Adjuster License according  to jurisdictional requirements.      

Medical Claim Analyst – (Nationwide)

Under direct supervision, processes medical only claims within authority, processes other claims open only for the administration of medical benefits (i.e. maintenance claims without actuarial reserves); approves payments and claimant reimbursements on lost time disability claims, within authority, after compensability has been determined. Two or more years of experience as a Claim Clerk or the equivalent Understanding of basic medical terminology and appropriate medical tests for claimed conditions. Knowledge of claim processing and claim policies and procedures.

Property Adjuster - Crawford & Company – (Nationwide)

Examines claims forms, policies and endorsements, client instructions and other records to determine coverage’s.  Investigates claims by interviewing claimants and witnesses, obtaining official reports, by inspecting physical damage, and by comparing claim information with evidence.  Prepares reports by collecting and summarizing information required by client, local, state and federal government and by Crawford.  Presents evidence at legal proceedings, producing reports and other documents as evidence.   Makes sales calls by calling on local businesses to solicit new business or to maintain existing clients.  Previous experience as a claims adjuster or must complete Crawford specified adjuster training if no experience. Requires high school diploma; advanced education beyond high school strongly preferred. Must be licensed as required by state and local jurisdictions.   Outside adjusters must have a valid driver’s license.

 Apply for these and other openings at “Careers”

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www.choosebroadspire.com or www.crawfordandcompany.com