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Sr Claim Examiner- WC

brea, ca • Posted 4 days ago
Remote Contract Business and Financial Operations Occupations
Job Description
Description:
  • Sr Claim Examiner- WC
  • 04-month contract with possible extension or conversion
  • Remote

Note: Must have multiple years'experience handling CA WC. Must work in PST hours .
Duties:
  • Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
  • Manages all aspects of investigative activity on complex claims.
  • Directs the discovery and litigation strategy with legal counsel.
  • Analyzes claims activity and prepares reports for clients/carriers and management.
  • Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost-effective manner and ensuring timely issuance of disbursements.
  • Settles claims promptly and equitably and issues company drafts in payments for claims within authority limits.
  • Develops subrogation and third-party recovery potential and follows reclaim procedures.
  • Analyzes claims activities and prepares reports for clients, carriers and/or management.
  • Participates in claim reviews.

Skills:
  • Ability to work independently while assimilating various technical subjects.
  • Strong written and oral communication, negotiation and presentation skills.
  • Advanced analytical and problem-solving skills, with the ability to manage and prioritize multiple projects.

Education:
  • Bachelor's degree or equivalent experience required.

Meet Your Recruiter
Ajeet Singh
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