Claims Examiner/Adjuster Trainee Remote position Must reside in the State of Maine
Claims Adjuster - Position Overview:
As a Claims Adjuster at NAHGA Claim Services, you will be responsible for investigating, evaluating, and paying secondary accident insurance claims. You will work closely with claimants, policyholders, and insurance carriers to ensure fair and prompt resolution of claims, in accordance with company policies and legal requirements. Your role is critical in determining the extent of the insurance companys liability and facilitating fair compensation for covered losses.
As a TPA (Third Party Administrator) Accident and Health Insurance Adjuster, you will begin with a robust training curriculum to broaden your exposure to all departments within the organization and familiarize yourself with the roles, responsibilities, systems, and workflow.
Key Responsibilities:
· Investigate Claims: Conduct thorough investigations to determine the validity of insurance claims, including review of documentation.
· Evaluate Claims: Analyze claims to determine coverage, liability, and appropriate settlement amounts, considering policy terms, applicable laws, and regulations.
· Negotiate Settlements: Communicate with claimants, attorneys, and other parties to negotiate fair and equitable settlements. Ensure that settlements are in the best interest of
· both the company and the policyholder.
· Documentation: Maintain accurate and detailed records of claim
· investigations, evaluations, and settlements. Prepare comprehensive
· documentation for each claim.
· Customer Service: Provide exceptional customer service to claimants, policyholders, and
· other stakeholders. Address inquiries and concerns promptly and professionally.
· Compliance: Ensure compliance of all claims with company policies, industry standards, and legal requirements. Participate in training and stay updated on changes in insurance and regulations.
Qualifications and Skills:
Minimum Experience: Prior experience in insurance, healthcare, or a customer service role is preferred. No more than 2 jobs in 4 years is preferred.
Education: High School Diploma or higher
Licensure/Certification: Upon completion of adjuster training, an adjusters license is required. The employee will be signed up for an adjusters class in preparation for taking an exam to acquire their license.
Skills:
· Strong analytical, mathematical, investigative, and problem-solving abilities.
· Excellent communication and interpersonal skills.
· Detail-oriented with a high level of accuracy.
· Proficient computer skills required to navigate multiple system applications.
· Eagerness to learn and develop professionally in the insurance industry.
· Ability to work independently and effectively in a team environment.
· High level of integrity and ethical standards.
Who we are:
Founded in 1991, NAHGA is a nationally recognized TPA (Third Party Administrator) specializing in the secondary accident insurance industry. NAHGA has developed a national reputation for excellence as a TPA and the scope of our client roster has expanded from boys and girls camps to K-12 school and sports programs to amateur sports leagues to college athletics programs at all interscholastic levels. We also customize claims adjudication programs, including high-deductible and self-funded plans, for businesses of all sizes. NAHGA Claims Services is a family-owned business with a rich history and commitment to providing exceptional customer service. NAHGAs Core Company Values:
· Integrity
Integrity at NAHGA means providing dependable, honest, and ethical service to our partners, claimants and our coworkers. Integrity is the cornerstone of our organizations values.
· Accountability
NAHGA takes responsibility for our words, our actions, and our results in all aspects of our business.
· Positivity
Positivity is a core value which shapes our entire culture. We are committed to an optimistic outlook; one of resilience and team spirit.
· Collaboration
NAHGA empowers each other to communicate, innovate, and partner together while recognizing one another's strengths and achieving our goals.
· Compassion
Compassion is at the heart of all our interactions. Here at NAHGA we are kind and caring to everyone we encounter .our clients, co-workers, family and friends.
Equal Opportunity:
NAHGA is an equal-opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Thank you for your interest in joining NAHGA Claim Services. We look forward to reviewing your application!
Job Type: Full-time
Pay: From $18.32 per hour
Expected hours: 40 per week
Benefits:
401(k)
401(k) matching
Dental insurance
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Professional development assistance
Vision insurance
Work from home
Schedule:
8 hour shift
Day shift
Monday to Friday
Location:
Maine (Required)
Work Location: Remote
Apply Now
As a Claims Adjuster at NAHGA Claim Services, you will be responsible for investigating, evaluating, and paying secondary accident insurance claims. You will work closely with claimants, policyholders, and insurance carriers to ensure fair and prompt resolution of claims, in accordance with company policies and legal requirements. Your role is critical in determining the extent of the insurance companys liability and facilitating fair compensation for covered losses.
As a TPA (Third Party Administrator) Accident and Health Insurance Adjuster, you will begin with a robust training curriculum to broaden your exposure to all departments within the organization and familiarize yourself with the roles, responsibilities, systems, and workflow.
Key Responsibilities:
· Investigate Claims: Conduct thorough investigations to determine the validity of insurance claims, including review of documentation.
· Evaluate Claims: Analyze claims to determine coverage, liability, and appropriate settlement amounts, considering policy terms, applicable laws, and regulations.
· Negotiate Settlements: Communicate with claimants, attorneys, and other parties to negotiate fair and equitable settlements. Ensure that settlements are in the best interest of
· both the company and the policyholder.
· Documentation: Maintain accurate and detailed records of claim
· investigations, evaluations, and settlements. Prepare comprehensive
· documentation for each claim.
· Customer Service: Provide exceptional customer service to claimants, policyholders, and
· other stakeholders. Address inquiries and concerns promptly and professionally.
· Compliance: Ensure compliance of all claims with company policies, industry standards, and legal requirements. Participate in training and stay updated on changes in insurance and regulations.
Qualifications and Skills:
Minimum Experience: Prior experience in insurance, healthcare, or a customer service role is preferred. No more than 2 jobs in 4 years is preferred.
Education: High School Diploma or higher
Licensure/Certification: Upon completion of adjuster training, an adjusters license is required. The employee will be signed up for an adjusters class in preparation for taking an exam to acquire their license.
Skills:
· Strong analytical, mathematical, investigative, and problem-solving abilities.
· Excellent communication and interpersonal skills.
· Detail-oriented with a high level of accuracy.
· Proficient computer skills required to navigate multiple system applications.
· Eagerness to learn and develop professionally in the insurance industry.
· Ability to work independently and effectively in a team environment.
· High level of integrity and ethical standards.
Who we are:
Founded in 1991, NAHGA is a nationally recognized TPA (Third Party Administrator) specializing in the secondary accident insurance industry. NAHGA has developed a national reputation for excellence as a TPA and the scope of our client roster has expanded from boys and girls camps to K-12 school and sports programs to amateur sports leagues to college athletics programs at all interscholastic levels. We also customize claims adjudication programs, including high-deductible and self-funded plans, for businesses of all sizes. NAHGA Claims Services is a family-owned business with a rich history and commitment to providing exceptional customer service. NAHGAs Core Company Values:
· Integrity
Integrity at NAHGA means providing dependable, honest, and ethical service to our partners, claimants and our coworkers. Integrity is the cornerstone of our organizations values.
· Accountability
NAHGA takes responsibility for our words, our actions, and our results in all aspects of our business.
· Positivity
Positivity is a core value which shapes our entire culture. We are committed to an optimistic outlook; one of resilience and team spirit.
· Collaboration
NAHGA empowers each other to communicate, innovate, and partner together while recognizing one another's strengths and achieving our goals.
· Compassion
Compassion is at the heart of all our interactions. Here at NAHGA we are kind and caring to everyone we encounter .our clients, co-workers, family and friends.
Equal Opportunity:
NAHGA is an equal-opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Thank you for your interest in joining NAHGA Claim Services. We look forward to reviewing your application!
Job Type: Full-time
Pay: From $18.32 per hour
Expected hours: 40 per week
Benefits:
401(k)
401(k) matching
Dental insurance
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Professional development assistance
Vision insurance
Work from home
Schedule:
8 hour shift
Day shift
Monday to Friday
Location:
Maine (Required)
Work Location: Remote
Apply Now