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Sr Claim Examiner- WC

TPI Global Solutions

  • Brea, CA
  • 6 days ago

    Highlights

    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.

    Numbers & Facts

    LocationBrea, CA
    IndustryComputer/IT Services
    Company Size1 to 9 employees
    Year Founded2016
    Websitehttps://www.shglobalsolutions.com

    Description

    Description:
    • Sr Claim Examiner- WC
    • 04-month contract with possible extension or conversion
    • Remote
     
    Note:
    Must have multiple years' experience handling CA WC. Must work in PST hours .
    Sr Claim Examiner- WC The examiner can work remotely.
    The adjuster to work pacific standard hours, core hours 8-5, about 40hrs a week.
    Sr. WC Adjuster knowledgeable of CA law and experience in claims handling CA venue
    Preferred:  SIP and CE hours per CA requirements

     
    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 4-8 years’ experience in Claims or similar organization

    About Company

    SH Global Solutions is a certified Service Disabled Veteran Owned Small Business (SDVOSB) headquartered in Maryland. Established in 2016 to modernize commercial and government technology to mitigate cybersecurity threats and to secure data centers from increasingly more frequent cyber attacks, we specialize in providing Information Technology (IT) solutions and services to government and commercial organizations. Our core areas of core expertise are focused in:

    ● Datacenter consolidation/optimization - this includes designing, procuring, and installing turnkey secure, modern infrastructure solutions including scalable and modular systems

    ● Professional program and project management services for large and complex projects

    ● In-building wireless solutions to enable 5G technology and connect to the growing Internet of Things (IoT)

    Our team is comprised of highly skilled and dedicated professionals, uniquely qualified in cutting-edge technology, and engineering, and in the rapid deployment and implementation of new technologies.  Our CEO is a retired United States Air Force Colonel and entrepreneur with over 25 years supporting the DOD, US Government agencies, and NATO worldwide.

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