Medical Claims Processor Jobs in Austin, TX (NOW HIRING)

Job Location: Marble Falls Branch - Marble Falls , TX 78654

Position Type: Full Time

Education Level: 2 Year Degree

Salary Range: $77,000.00 - $114,000.00

Travel Percentage: None

Job Shift: Day

Job Category: Claims Consultants

The Senior Auto Claims Adjuster is responsible for handling commercial auto losses, focusing on complex auto physical damage claims, disputed property damage liability claims, non-litigated bodily injury claims, and general liability claims.

• Investigate reports of loss by interviewing claimants, witnesses, and other involved parties, gathering evidence, police reports, photographs, and repair estimates
• Engage and manage external vendors as needed in the investigation and evaluation of reports of loss
• Determine liability by analyzing the facts of each case, including review of applicable laws and regulations
• Ensure timely vehicle inspections to assess the extent of damage and determine cost of repairs, working with independent adjusters, vendors, and body shops as needed
• Manage financial transactions associated with commercial auto claims, including reserves, payments, and recoverages, as well as negotiating settlements and ensuring fair compensation for loss
• Apply the terms and conditions of the appropriate coverage forms to facts of loss as reported or developed during investigations
• Consistently and frequently communicate with vehicle owners regarding the status of their claim, providing updates, answering questions, and ensuring a positive customer experience
• Accurately and thoroughly document claims with all pertinent activity and rationale for decisions made and actions taken; prepare detailed reports documenting findings, decisions, and justification for settlements reached
• Evaluate medical documentation to determine appropriate settlement amounts of third-party bodily injury claims
• Negotiate settlements of bodily injury claims with claimants and attorneys
• Ensure compliance with Medicare Secondary Payer Act
• Perform all actions relating to customers and companies in a manner that will avoid issues involving potential errors and omissions
• Participate in seminars and other training to maintain required licenses and for knowledge and skill development

This job description is intended to describe the level of work required of the person performing the position. Essential functions are outlined; however, other duties may be assigned, as needs arise, or as required to support the essential functions. Specific performance objectives may be developed each year to measure the performance of the tasks and functions listed in this job description.

Telecommuting opportunities vary by location, department, and business need and are subject to change, as needed. Each manager will provide details on any telecommuting opportunities, as well as scheduling, within their department.

• 3 – 5 years of previous auto claim handling experience preferred
• High school diploma or equivalent required
• Bachelor's degree preferred, but not required
• Possession of, or the ability to immediately attain, a Texas Adjuster’s License required

• Ability to interpret and correctly apply commercial auto coverage forms
• Excellent customer service aptitude
• Ability to work collaboratively and to resolve conflict using effective negotiation skills
• Ability to manage and prioritize multiple tasks
• Proficient PC skills, with a focus on the Microsoft Office suite of products (Excel, Word, Outlook, Teams, etc.)
• Understand medical terminology
• Self-motivated, with the initiative to prioritize and be self-directed
• Ability to communicate effectively, both verbally and in writing
• Excellent interpersonal skills, with the ability to interact effectively with both colleagues, customers, and managers, across all levels
• Ability to promote and maintain a team environment, willing to find accommodating solutions for our customers, companies, and the Agency
• Ability to successfully adhere to company policies and procedures, as well as maintain strict confidentiality

• Fast-paced, multi-tasking, office environment with periodic high disruption and changing priorities
• Ability to perform approximately 80% sedentary work, exerting up to 10 pounds of force occasionally, and negligible force frequently
• Ability to lift up to 20 pounds occasionallyiped? processor? Ok