Claims Examiner - Workers Compensation (Hourly)

Job Title: Claims Examiner - Workers Compensation (Hourly)
Location (On-site, Remote, or Hybrid?): Remote in California
Contract Duration: 3 months

PRIMARY PURPOSE:
To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Education & Licensing

• Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.

Experience

• Five (5) years of claims management experience or equivalent combination of education and experience required.
• High School Diploma or GED required. Bachelor's degree from an accredited college or university preferred.
• Professional certification as applicable to line of business preferred.