Title: Sr. Claim Examiner/Workers Compensation
Duration: 6 months contract
Location: Remote
Required: Claim or Workers Compensation license for CA
JOB Description:
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 authorize 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.
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.