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.