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Sr Claim Examiner- WC

Remote: 
Full Remote
Contract: 
Full time
Work from: 
United States

Offer summary

Qualifications:

Bachelor's degree or equivalent experience., 4-8 years of experience in Claims or a similar organization., Workers Compensation (WC) Adjuster License required according to jurisdictional requirements., Preferred industry designations include IIA, AIC, AEI, and/or CPCU..

Key responsabilities:

  • Interprets and makes decisions on complex policy coverages for claims submitted.
  • Manages investigative activities on complex claims and directs litigation strategy with legal counsel.
  • Analyzes claims activity and prepares reports for clients, carriers, and management.
  • Establishes reserves and authorizes payments, ensuring timely disbursements and equitable settlements.

TalentBurst, an Inc 5000 company logo
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: 4+ months
Shift: PST
NOTE:
  • Role is Remote ( currently, subject to change )
  • Candidates should be located by Closest offices just in case: Brea, Folsom or Fresno (Or if they are exceptional consideration to other parts of US)
Are there any specific licenses the candidates need to have?
  • SIP if they have it or WCCA/WCCP but not mandatory "

Details:
  • Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
  • Manage 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 authorize 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, careers 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.
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: - Industry designations such as IIA, AIC, AEI and/or CPCU.
#TB_EN

Required profile

Experience

Industry :
Human Resources, Staffing & Recruiting
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Hard Skills

Claims And Litigation ManagementPresentation TrainingClaims And Litigation ManagementIDoc (Intermediate Document)

Other Skills

  • Analytical Skills
  • Problem Solving
  • Negotiation
  • Time Management
  • Communication
Are you interested?

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