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Sr Claim Examiner- WC

extra holidays
Remote: 
Full Remote
Contract: 
Experience: 
Senior (5-10 years)

Offer summary

Qualifications:

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

Key responsabilities:

  • Interprets complex policy coverages
  • Manages investigative activities on complex claims
  • Analyzes claims activity and prepares reports
  • Establishes reserves and authorizes payments
  • Develops subrogation and third party recovery potential
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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

Title: Sr Claim Examiner- WC
Location: REMOTE
Duration: 3 months plus extensions

MUST SUBMIT Valid NY Adjusters License
Details:
  • 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.
Looking fort:
  • 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
  • Report Writing
  • Analytical Skills
  • Time Management
  • Communication
  • Problem Solving

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