Senior Claims Examiner
infojiniSeattle (WA)
Senior Claims Examiner
Posted 13 days ago
infojiniSeattle (WA)
SENIORITY
Senior
About the role
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
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