Public Entities Claims Examiner Iii

3 days ago

Chino Hills, United States TRISTAR RISK MANAGEMENT Full time

***:Responsible for the prompt review of claims to determine coverage for loss/damage/injury. Conduct an efficient claim examination and investigation leading to the final resolution of liability claims, including matters in litigation. Frequent contact and interaction with involved parties including claimants and their legal representatives will be required along with Defense Counsel. Recommendations regarding loss exposure and associated reserve and settlement strategy will be effectively communicated to the client.

**DUTIES AND RESPONSIBILITIES**:

- Review, process and conclude assigned claims including investigation and evaluation mid-level exposure to complex Public Entity Auto and/or General Liability Casualty Claims.
- Review and interpret Memorandum of Coverage.
- Oversee and direct outside investigative service providers and work closely with the client and client counsel and investigative services to advance the claim to conclusion.
- Maintain an ongoing diary.
- Continually assess exposure and evaluate for accurate reserves and settlement recommendation.
- Prepare Loss Reports providing thorough analysis of liability and damages.
- Where applicable, determine if subrogation and/or risk transfer exists and initiate recovery efforts at the direction of the client.
- Document all correspondence, reports, discussions and decisions in the claim file record.
- Provide outstanding service to the client.
- Assist Supervisors and Claim Department with requested tasks or special projects.
- Other duties as assigned.

Position can be Hybrid or Full Time remote/working from home**.**

Education/Experience: High School Diploma or GED required; Bachelor’s degree in related field (preferred) and a minimum of three to five (3 to 5) years Public Entity Auto and General Liability Casualty related experience; or equivalent combination of advanced education and experience.

Special Requirements:

- At least 3 years of Commercial Automobile and General Liability claims experience required.
- Knowledge of claims handling concepts, practices and techniques, including but not limited to coverage issues and product line knowledge.
- Demonstrated verbal and written communications skills.
- Demonstrated advanced analytical, decision-making and negotiation skills.
- Computer proficiency.

Preferred Skills:

- Ability to communicate effectively and clearly, both orally and in writing.
- Ability to manage relationships in a fast-paced environment, while demonstrating problem solving and decision-making skills to work with customers.
- Good analytical abilities to review, exercise judgment and evaluate claims in order to make sound decisions with a mínimal amount of supervision.
- Excellent customer service skills.
- An understanding of the litigation process and case valuation in multiple jurisdictions.
- Ability to carry out detailed written or verbal instructions, ability to respond to requests effectively and efficiently and exhibit good common sense.
- An ability to handle assigned claims following company guidelines and industry best practices with a mínimal amount of supervision.
- Time management skills, organizational skills and ability to prioritize issues and tasks.
- Independence, flexibility, and creativity.

Other Qualifications:

- California Adjuster License considered a plus.

  • Senior Workers' Compensation Claims Examiner

    1 month ago

    Woodland Hills, United States ICW Group Full time

    Are you looking for more than just a job? Do you want to have a voice and feel a sense of belonging? At ICW Group, we hire innovative people who consistently adapt, grow and deliver. We believe in hard work, a fun work environment, and embracing creativity that only comes about when talented people collaborate to develop solutions. Our mission is to create...

  • Senior Workers' Compensation Claims Examiner

    4 weeks ago

    Woodland Hills, United States ICW Group Full time

    Are you looking for more than just a job? Do you want to have a voice and feel a sense of belonging? At ICW Group, we hire innovative people who consistently adapt, grow and deliver. We believe in hard work, a fun work environment, and embracing creativity that only comes about when talented people collaborate to develop solutions. Our mission is to create...

  • Workers' Compensation Claims Examiner

    1 month ago

    Woodland Hills, United States ICW Group Full time

    Are you looking for more than just a job? Do you want to have a voice and feel a sense of belonging? At ICW Group, we hire innovative people who consistently adapt, grow and deliver. We believe in hard work, a fun work environment, and embracing creativity that only comes about when talented people collaborate to develop solutions. Our mission is to create...

  • Workers' Compensation Claims Examiner

    4 weeks ago

    Woodland Hills, United States ICW Group Full time

    Are you looking for more than just a job? Do you want to have a voice and feel a sense of belonging? At ICW Group, we hire innovative people who consistently adapt, grow and deliver. We believe in hard work, a fun work environment, and embracing creativity that only comes about when talented people collaborate to develop solutions. Our mission is to create...

  • Remote California Workers Comp Sr. Claim Examiner

    2 months ago

    El Dorado Hills, United States Randstad North America, Inc. Full time

    Do you have at least 4 years of experience working and analyzing Workers Compensation Claims and decisioning on them for the State of California? Do you hold your OSIP Certificate? Do you desire to continue doing what you love from the comfort of you Examiner, Worker, Workers Compensation, Remote, Claims, Retail, Staffing

  • Remote California Workers Comp Sr. Claim Examiner

    4 weeks ago

    El Dorado Hills, United States Randstad North America, Inc. Full time

    Do you have at least 4 years of experience working and analyzing Workers Compensation Claims and decisioning on them for the State of California? Do you hold your OSIP Certificate? Do you desire to continue doing what you love from the comfort of you Examiner, Worker, Workers Compensation, Remote, Claims, Retail, Staffing

  • Workers Compensation Claims Examiner West Hills, Ca

    2 weeks ago

    West Hills, United States Sedgwick Full time

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...

  • Medical Only Claims Examiner I

    4 weeks ago

    Woodland Hills, United States ICW Group Full time

    Are you looking for more than just a job? Do you want to have a voice and feel a sense of belonging? At ICW Group, we hire innovative people who consistently adapt, grow and deliver. We believe in hard work, a fun work environment, and embracing creativity that only comes about when talented people collaborate to develop solutions. Our mission is to create...

  • Claims Team Lead

    2 weeks ago

    West Hills, United States Sedgwick Full time

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...

  • Claims Processor

    2 weeks ago

    Woodland Hills, United States MedPOINT Management Full time

    **Summary**: Responsible for accurate review and input of claims in accordance with outside regulation, internal production standards and contractual obligations of the organization. **Duties and Responsibilities**: - Accurately review all incoming claims to verify if required fields are populated. - Process claims information into the computerized claims...

  • Title Examiner

    2 weeks ago

    Auburn Hills, United States Proliant Settlement Systems Full time

    Proliant Settlement Systems is currently looking for a full-time Title Examiner. This person should be friendly, organized, attentive to detail, and able to work as part of a team as well as independently.The Title Examiner examines public records of real property to determine whether the title is free of defeats by researching title resources and other...

  • Title Examiner

    4 days ago

    Auburn Hills, United States Proliant Settlement Systems Full time

    Job DescriptionJob DescriptionProliant Settlement Systems is currently looking for a full-time Title Examiner. This person should be friendly, organized, attentive to detail, and able to work as part of a team as well as independently.The Title Examiner examines public records of real property to determine whether the title is free of defeats by researching...

  • Claims Team Lead

    3 weeks ago

    West Hills, United States Sedgwick Full time

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...

  • Supervisor Claims

    4 days ago

    Mission Hills, United States Providence Full time

    **Description** Working under the direction of the Manager, Claims, this position has direct responsible for the supervision of staff and for overseeing the day-to-day operations of the Claims Processing and UM Denial Letter Units. Additional responsibilities include reporting functions to ensure compliance with AB1455, attention to CMS guidelines and...

  • Recovery Examiner

    1 week ago

    Woodland Hills, United States MedPOINT Management Full time

    **Summary**: **Duties and Responsibilities**: - Process and post all daily refund checks received. - Prepares weekly and monthly reports to management of monthly refund requests and refunds received. - Prepares monthly reports to management and IPA analysts of reconciled reports of refund checks with Accounts Receivables. - Review refund requests for...

  • Vision Claims

    3 weeks ago

    Wellesley Hills, United States DentaQuest Full time

    You are as unique as your background, experience and point of view. Here, you’ll be encouraged, empowered and challenged to be your best self. You'll work with dynamic colleagues - experts in their fields - who are eager to share their knowledge with you. Your leaders will inspire and help you reach your potential and soar to new heights. Every day, you'll...

  • Claims Representative

    6 days ago

    West Hills, United States Sedgwick Full time

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...

  • Associate Analyst, Claims

    1 month ago

    North Richland Hills, United States XPO Full time

    Job Description:What you'll need to succeed as an Associate Analyst, Claims at XPOMinimum qualifications:Bachelor's degree or equivalent related work or military experienceExceptional customer service skillsAble to communicate with management regarding the claim decision-making process Excellent written and verbal communication skillsPreferred...

  • Associate Analyst, Claims

    4 weeks ago

    North Richland Hills, United States XPO Full time

    Job Description:What you'll need to succeed as an Associate Analyst, Claims at XPOMinimum qualifications:Bachelor's degree or equivalent related work or military experienceExceptional customer service skillsAble to communicate with management regarding the claim decision-making process Excellent written and verbal communication skillsPreferred...

  • Clinical Research Data Specialist III- Cheng Lab, Heart Institute

    4 weeks ago

    Woodland Hills, United States CEDARS-SINAI Full time

    Job Description The Smidt Heart Institute reflects Cedars-Sinai's steadfast dedication to heart disease and research innovation giving patients access to the highest level of care. Year after year, thousands of people trust their hearts to Smidt Heart Institute at Cedars-Sinai. Our cardiologists, cardiac surgeons and specialized care teams treat the full...