Claims Specialist

Job Title: Claims Examiner/ Claims Specialist

Location: Portland, OR

Duration: 3 Months (Contract to Hire- CTH)

Job Schedule: Full time in office, then hybrid 3 days in office, 2 days work from home. (In office Tues-Thurs, WFH Monday/Friday)

Work schedule: 8:00am-4:30pm PCT--1/2 hour lunch break

Interview process: Possible virtual screening call, followed by on site interview

• Under limited supervision, receives assignments and reviews claim and policy information to provide background for investigation and may determine the extent of the policy’s obligation to the insured depending on the line of business.
• Contacts, interviews and obtains statements from insureds, claimants, witnesses, physicians, attorneys, police officers, etc. to secure necessary claim information.
• Evaluates facts supplied by investigation to determine extent of liability of the insured, if any, and extent of the company’s obligation to the insured under the policy contract.
• Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties etc.
• Sets reserves within authority limits and recommends reserve changes to Team Leader.
• Prepares and submits to Team Leader unusual or possible undesirable exposures.
• Settles claims promptly and equitably.
• Obtains releases, proofs of loss or compensation agreements and issues company drafts in payments for claims.
• Informs claimants, insureds/customers or attorney of denial of claim when applicable.

• 2+ or more years’ experience handling workers’ compensation claims.
• Strong communication and interpersonal skills to effectively interact with claimants, customers, insureds, brokers, attorneys, etc., in a positive manner regarding losses.
• Ability to self-motivate and work independently.
• Knowledge of company products, services, coverages, and policy limits, along with awareness of the company’s claims best practices.

Bachlor degree or WC Insurance experience