| Department: | 06311 | SRMS | R0036 | BUS : BP WC Brea - 06311 | | Job Category: | Claims | | Job Code: | Sr Claim Examiner- WC:BS0160 | | Job Title: | Sr Claim Examiner- WC | | Keywords: | | | Number of Positions: | 2 | | | | Remaining Positions: | 2 | | | | 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 | | |
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| | Client Location | | Country: | United States | | State/Province: | California | | City: | Brea | | Address: | 675 Placentia Avenue, Suite 350, CA0001 | | POSTAL CODE: | 92821 |
| | Work Location | | Same as Client Location | | | Other Client Location | | Work Completed Offsite | | Country: | United States | | State/Province: | California | | City: | brea | | Street Address: | | | Street Address 2: | | | POSTAL CODE: | 92821 |
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| | Start Date: | 09/28/2026 | Hours Per Week: | 40.00 | | Est. End Date: | 01/01/2027 | Hours Per Day: | 8.00 | | Schedule Notes: | | Days Per Week: | 5.00 | | | Part Time or Full Time: | Part Time |
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