Claims Examiner

1 month ago


San Diego, United States Insight Global Full time

Location: Onsite in Mission Valley

Duration: 3-6 month contract with potential to extend or convert


Job Summary

Administer self-insured Workers’ Compensation claims. Provide informal training and guidance to less senior employees. Ensure proactive and cost-effective claims management. Occasionally lead department process improvement initiatives. Reports to the Workers’ Compensation Manager. Will lead and set example for less senior employees. Communicate directly with Workers’ Compensation Manager, Medical Providers, Production, Workers’ Compensation Assistants, Vendors, Attorneys, Department of Labor, and State WCAB officials.

ESSENTIAL FUNCTIONS AND DUTIES

  • Administer complex and highly litigated self-insured workers’ compensation claims.
  • Provide informal training and mentoring to less senior employees.
  • Ensure cost-effective and optimal resolution of claims.
  • Maintain proactive claims management.
  • Occasionally lead departmental process improvement initiatives.
  • Demonstrate mature judgement in settlement negotiations within designated authority levels.
  • Other responsibilities and duties as assigned.

MUST HAVES:

  • B.S. or B.A. in Business in Finance or Business Management, will consider Liberal Arts, or equivalent industry experience.
  • Complete a two (2) year training program or equivalent industry experience.
  • Complete five-course IEA program and obtain W.C.C.A. certificate.
  • Obtain Self-Insurance Administrator Certificate.
  • Occasional educational segments on company and on own time to maintain workers’ compensation claims adjuster certification pursuant to California Code of Regulations. Company pays tuition (100%) and supplies.
  • Timely and effectively manage claims to ensure lowest cost within letter of the law.
  • Excellent written and communication skills.
  • Actively participates in implementing and monitoring continuous improvement initiatives to improve safety, improve quality, reduce cycle time, and reduce costs.
  • Individual must be alert, communicative, analytical, and composed. Above average reasoning ability and interpersonal skills required. Working environment consists of an office setting


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