Claim Review Specialist I Job at Code Blue LLC
Job Summary:
As a member of our Technical Review team, it will be our goal to help develop you into an expert within the property claims industry. You’ll go through rigorous certification courses and a variety of training modules aimed to help you become an expert in the fields of water mitigation and property restoration. Whether you’re new to the industry or a seasoned vet, we’ll help you acquire the skills and knowledge to turn this position into a rewarding, challenging, and fulfilling career.
Upon completing training, our team’s primary responsibility is reviewing invoices of work completed by contractors to ensure all work that was completed was done according to industry standards. If any deviations are identified, our team will work directly with the contractor to gather additional details to support the work that was completed. If deviations still exist after additional information is provided, our team’s job is to work with the contractor further to identify what the standards could allow and don’t allow to reach an agreeable invoice.
The Technical Review Specialist position is the third tier within the unit. Team members that advance to this tier focus on handling fire and contents claims in addition to mold and larger water losses. Team members within this position will also largely be responsible for handling the commercial claims assigned to the team.
General Duties and Responsibilities:
- Complete detailed reviews of claims and compare against industry standards to identify potential deviations
- Discuss and coordinate activities with adjusters and contractors to identify why work may have been completed outside of the industry standards
- Work with contractors to obtain detailed information on claim activities including moisture readings, sketches, photos, and other documentation
- Review potential deviations with contractors to determine what work was completed within the standards and what wasn’t
- Create estimates and sketches within Xactimate to facilitate the claims settlement process
- Use the review findings to have a final discussion with the contractor to reach an agreed settlement amount for the claim
- Provide a written summary of the review based on IICRC standards to submit to the carrier upon completion
- Receive, enter, and manage insured-hired claims including handling follow-up for documentation until claim can be converted to a Technical Review
- Work directly with Supervisors or senior team members to ensure claims are handled properly
- Enter claim details and results into company systems for tracking and reporting purposes
- Adhere to all company and department policies
Educational Requirements:
A high school diploma/GED is required. An Associate’s or bachelor’s degree is preferable or the equivalent combination of education, training, and work experience.
General Knowledge, Skills & Abilities:
- Strong customer service skills to allow proper interaction with all stakeholders
- Thorough knowledge of the company’s products, services, and business operations to assist in reporting process and resolution to customer inquiries
- Excellent verbal and written communication skills
- Must be detail-oriented
- Demonstrated problem solving and analytical skills
- Ability to work independently while seeking out support as needed
Other:
- Office or Call Center 24/7/365 environment, Remote opportunities available
- Business Casual dress; Business Professional dress required for certain events
- Full-time position; overtime infrequently required due to surges in claim volume
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