Sr Claim Examiner- WC

Brea, CA - USA

Monthly Salary: Not Disclosed

Posted on: 8 hours ago

Vacancies: 1 Vacancy

Job Summary

Job Title: Sr Claim Examiner- WC

Location: Brea CA 92821

Summary of Job:

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 and directs the discovery and litigation strategy with legal counsel.

Must-have/Required 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.
Bachelors degree or equivalent experience.
Technical claims investigations/settling experience with 4-8 years experience in Claims or similar organization.
Workers Compensation (WC) Adjuster License required according to jurisdictional requirements.

Nice-to-have Skills:

Industry designations such as IIA AIC AEI and/or CPCU.

Key Responsibilities and 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.
Authorizes payments within scope of authority and settles claims in the most cost effective manner.
Ensures 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.
Participates in claim reviews.

Job Title: Sr Claim Examiner- WC Location: Brea CA 92821 Summary of Job: 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 an...