Sr Claim Examiner- WC CA

1 day ago


brea, United States TalentBurst Full time
33897371
Sr Claim Examiner- WC
Location : 675 Placentia Avenue, Suite 350, Brea CA 92821
Hybrid role & California required License and Spanish is a Plus ( Speak, Read )
Duration : 3 Months

Description :
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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