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Sr Claim Examiner- WC
Location: Folsom, CA (remote)
Duration: 06+ Months Contract
Position Description
Location: Folsom, CA (remote)
Duration: 06+ Months Contract
Position 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 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.
- 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.
- Bachelor's degree or equivalent experience.
- Technical claims investigations/settling experience with 4-8 years’ experience in Claims or similar organizations.
- Workers Compensation (WC) Adjuster License required according to jurisdictional requirements.
- Preferred: - Industry designations such as IIA, AIC, AEI and/or CPCU
