Senior Claims Examiner
Infojini
Position: Sr Claims Examiner- Workers Compensation (CA)
Location: 100% Remote
Duration: 04+ months contract with strong possibility of extension
Shift Timing: Mon- Fri: 8 AM- 5 PM PST (40 hrs/week)
JOB ID-
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 CA 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.
Required Skills:
- Knowledgeable of California law and experience in claims handling, CA venue
- 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:
- SIP and CA hours per CA requirements
- Industry designations such as IIA, AIC, AEI and/or CPCU
Vacancy posted 3 days ago
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