Claims Adjuster for Liability in Evesham Township, NJ at Pride Health

Date Posted: 11/16/2019

Job Snapshot

Job Description

Pride Health is currently seeking a Liability Claims Adjuster for a permanent opportunity in Marlton, NJ. This is a full time, permanent opportunity with full benefits.

Responsibilities:

  • Manages mid-level general liability claims by gathering information to determine liability exposure; assign reserve values to claims, making claims payments as necessary, and settling claims up to designated authority level.
  • Approves and processes assigned claims, determines, benefits due, and manages action plan pursuant to the claim or client contract.
  • Communicates claims action with claimant and client.
  • Ensures claim files are properly documented and claims coding is correct.
  • May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
  • Maintains professional client relationships.

Qualifications:

  • Bachelor's degree preferred
  • Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business.
  • 4 years of claims management experience.

If interested, please apply directly to this positing or email april.branch@pride-health.com