REMOTE POSITION / CLAIMS PROCESSOR

Claims Examiner - Workers Compensation

Our client, a Business Solutions company, is looking for a Claims Examiner - Workers Compensation for their Roseville, CA/Remote location. Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.

Negotiates settlement of claims within designated authority.

Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.

approves and makes timely claim payments and adjustments; Manages the litigation process; ensures timely and cost effective claims resolution.

Coordinates vendor referrals for additional investigation and/or litigation management.

Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.

Reports claims to the excess carrier; Communicates claim activity and processing with the claimant and the client; Ensures claim files are properly documented and claims coding is correct.

Supports the organization's quality program(s).

Minimum 3 years of relevant CA WC claims experience is mandatory

California WC Claims handling experience

Bachelor's degree from an accredited college or university preferred. Experience Five (5) years of claims management experience or equivalent combination of education and experience required.

Excellent growth and advancement opportunities