Department :
06311 SRMS R0036 BUS : BP WC Brea - 06311
Job Category : Claims
Claims
Job Code :
Sr Claim Examiner- WC : BS0160
Job Title :
Sr Claim Examiner- WC
Keywords :
Number of Positions :
Remaining Positions :
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. - 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. Preferred : - Industry designations such as IIA, AIC, AEI and / or CPCU
Languages : Spanish
Spanish
Read
Write
Speak
Certifications & Licenses :
CPCU
Attachments :
Skills and Experience
Skills : Required
Required
- CLAIMS PAYMENTS
- CLAIMS LITIGATION
- CPCU
- PRESENTATION SKILLS
- WORKERS COMPENSATION CLAIMS HANDLING
Additional
- PROBLEM SOLVING
- TECHNICAL CLAIMS
- CLAIMS
- LITIGATION STRATEGY
- PAYMENTS
Languages :
Spanish( Speak, Read )
Minimum Degree Required :
Completed High School (Diploma or GED)
Also Preferred : Location
Location
Client Location
Country : United States
United States
State / Province : California
California
City : Brea
Brea
Address :
675 Placentia Avenue, Suite 350, CA0001
POSTAL CODE : 92821
92821
Work Location
Same as Client Location
Other Client Location
Work Completed Offsite
Schedule
Start Date : 10 / 04 / 2024
10 / 04 / 2024
Hours Per Week : 40.00
40.00
Est. End Date : 12 / 31 / 2024
12 / 31 / 2024
Hours Per Day : 8.00
8.00
Schedule Notes : Days Per Week :
Days Per Week : 5.00
5.00
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