Senior Claims Examiner

Position: Sr Claims Examiner- Workers Compensation (CA)

Location: 100% Remote

Duration: 04+ months contract with strong possibility of extension

Shift Timing: Mon- Fri: 8 AM- 5 PM PST (40 hrs/week)

JOB ID- 37563378

The examiner can work remotely, The adjuster to work pacific standard hours, core hours 8-5, about 40hrs a week, Sr. WC Adjuster knowledgeable of CA law and experience in claims handling, CA venue

Preferred: SIP and CA hours per CA requirements

Duties:

• 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.

Required Skills:

• Knowledgeable of California law and experience in claims handling, CA venue


• 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:

• SIP and CA hours per CA requirements


• Industry designations such as IIA, AIC, AEI and/or CPCU