Top 6 Claims examiner ii Jobs in Nevada

Auditor/Investigator II
Qlarant —Nevada
- $57,512 - $85,839 a year
- Full-time
- Remote
- Mid-level
- Analysis skills
- Bachelor's degree
Quick Apply
Claims Examiner II - Marine Personal Lines
Markel Service Inc. —Henderson, NV
- $62,000 - $85,800 a year
- Email
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- AD&D insurance
- Employee stock purchase plan
Quick Apply
1d
Claims Assistant
CorVel Corporation —Las Vegas, NV
- $13.38 - $23.42 an hour
- Full-time
- Microsoft Excel
- Customer service
- Computer literacy
- Health savings account
- Disability insurance
Quick Apply
9d
Claim Examiner II, Construction
Markel Service Inc. —Henderson, NV
- $62,400 - $85,800 a year
- Email
- Hybrid work
- Customer service
- Mid-level
- Office
- AD&D insurance
- Employee stock purchase plan
Quick Apply
1d
Claims Specialist, Workers Compensation - West Region
Liberty Mutual —Las Vegas, NV
- $61,000 - $113,000 a year
- Full-time
- Bachelor of Science
- Mid-level
- Office

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Claims Examiner II - Marine Personal Lines
Markel Service Inc. —Henderson, NV
Must have or be eligible to receive any necessary claims adjuster license(s). This includes race; color; sex; religion; creed; national origin or place of birth…
$62,000 - $85,800 a year
Quick Apply
1d

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claims examiner ii jobs near nevada

Auditor/Investigator II

Qlarant -
Nevada

Quick Apply

Job Details

Full-time
$57,512 - $85,839 a year

Qualifications

Stakeholder management

Full Job Description

Job Summary:

Ensures the integrity and accuracy of claims processes and protocols. Collects data for audits/investigations into claims, utilizing a combination of analytical skills and attention to detail, reviewing documentation, interviewing involved parties, and communicating with various stakeholders to gather relevant information for successful resolution and closure. Identifies opportunities to target fraud, waste, and abuse or discrepancies in claims submissions. Adheres to industry regulations and policies for managerial follow-up. Analyzes data in order to effectively assess the validity of claims. Provides accurate recommendations to management for claim resolution and closure. Documents and inputs all findings, while preparing comprehensive reports that may be used for legal or audit/investigative purposes.

Essential Functions:

Conducts routine and impartial audits/investigations from start to closure into customer claims, ensuring accurate and fair assessments of claims validity.
Provides customer service by addressing inquiries and concerns, and escalates audit/investigation, as needed.
Compiles detailed and organized records of audit/investigation findings, ensuring accuracy and compliance with legal and regulatory requirements.
Applies functional knowledge to create and implement strategies to identify and prevent fraudulent activities, safeguarding the integrity of the claims process.
Conducts interviews with relevant witnesses, claimants, and other stakeholders to gather additional information and perspectives on claims.
Communicates with appropriate internal teams to ensure the proper processing of audits/investigations, while adhering to legal and regulatory standards.
Communicates audit/investigation findings clearly and professionally to customers, claimants, and other stakeholders, managing expectations and providing updates.
Assists in providing training and support to other auditors/investigators, contributing to the continuous improvement of investigative processes.

Level of Supervision Received:
Plans and arranges own work; works with manager to prioritize projects.

Education (can be substituted for experience):
Minimum Bachelor's Degree required

Work Experience (can be substituted for education):
2 - 4 years of experience required; 5 - 7 years preferred

Certification(s):
Certified Fraud Examiner preferred

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Refine Your Search

claims examiner ii jobs in nevada

Auditor/Investigator II

Claims Examiner II - Marine Personal Lines

Claims Assistant

Claim Examiner II, Construction

Claims Specialist, Workers Compensation - West Region

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