Claims Examiner- Worker's Compensation (remote in CA only)
Claim Examiner - Workers? Compensation (remote)
Location: Must reside in the state of California...
Pay: Depends on experience
Duties of the Claim Examiner - Workers? Compensation:
? Receive claim assignments and confirm policy coverages.
? Interpret and make decisions using independent judgment on moderate difficulty claims and policy coverages.
? Investigate, evaluate, negotiate, and adjudicate first and third-party claims to determine validity and verify the extent of damage. This involves telephone contact with clients, claimants, witnesses, or other relevant parties.
? Analyze claims activity and prepare reports for clients, carriers, and management.
? Establish reserves, authorize payments within the scope of authority, and settle claims in a cost-effective manner, ensuring timely disbursements.
? Make prompt and equitable settlement decisions, issuing company drafts for authorized claims.
? Develop subrogation and third-party recovery potential, following reclaim procedures.
? Participate in claim reviews.
Job Requirements
Skills Required for the Claim Examiner - Workers? Compensation:
? Ability to work independently while assimilating various technical subjects.
? Strong verbal and written communication skills.
? Demonstrated ability to gather and analyze information, determine a course of action, and implement the selected approach.
? Proficiency in problem-solving and identifying solutions.
? Effective interpersonal skills for dealing with external sources and colleagues at all levels.
Education:
? Bachelor?s degree or equivalent experience required.
? 1-3 years of comprehensive claims investigations/settling experience in Workers? Compensation or a similar organization
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