Claim Examiner- WC

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. Duties:Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.

Description:

• Sr Claim Examiner- WC
• 03-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.
• Comprehensive claims investigations/settling experience 1-3 years’experience in Claims or similar organization

 
Thanks & Regards