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.
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:
Bachelors 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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