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Sr Claim Examiner- WC

extra holidays
Remote: 
Full Remote
Contract: 
Experience: 
Senior (5-10 years)
Work from: 
Oregon (USA), United States

Offer summary

Qualifications:

Bachelor's degree or equivalent experience, 4-8 years experience in Claims, Workers Compensation Adjuster License required, Technical claims investigations/settling experience.

Key responsabilities:

  • Interprets policy coverages and makes claim decisions
  • Manages investigative activities on complex claims
  • Prepares reports for clients, carriers, and management
  • Establishes reserves and authorizes payments
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TalentBurst, an Inc 5000 company Human Resources, Staffing & Recruiting Large https://www.talentburst.com/
1001 - 5000 Employees
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Job description

Job Title:-Sr Claim Examiner- WC
Location:- Open For 100% Remote  
Duration: 2+ months with possible extensions 


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.

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.

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

#TB_EN

Required profile

Experience

Level of experience: Senior (5-10 years)
Industry :
Human Resources, Staffing & Recruiting
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Decision Making
  • Negotiation
  • Analytical Skills
  • Problem Reporting
  • Time Management
  • Presentations
  • Communication
  • Problem Solving

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