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Claims Examiner – Workers Compensation

Claims SpecialistClaims SpecialistFull TimeRemoteSeniorTeam 10,001Company Site

Location

California

Posted

27 days ago

Salary

$85K - $95K / year

Seniority

Senior

Bachelor Degree5 yrs expEnglish

Job Description

• Analyze complex or technically difficult workers' compensation claims to determine benefits due • Work with high exposure claims involving litigation and rehabilitation • Ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements • Identify subrogation of claims and negotiate settlements • Manages claims through well-developed action plans to an appropriate and timely resolution • Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner • Ensures claim files are properly documented and claims coding is correct

Job Requirements

  • Bachelor's degree from an accredited college or university preferred
  • Professional certification as applicable to line of business preferred
  • Five (5) years of claims management experience or equivalent combination of education and experience required
  • Subject matter expert of appropriate insurance principles and laws for line-of-business handled
  • Excellent oral and written communication, including presentation skills
  • PC literate, including Microsoft Office products
  • Analytical and interpretive skills
  • Strong organizational skills
  • Good interpersonal skills
  • Excellent negotiation skills
  • Ability to work in a team environment
  • Ability to meet or exceed Service Expectations

Benefits

  • Medical
  • Dental
  • Vision
  • 401k and matching
  • PTO
  • Disability and life insurance
  • Employee assistance
  • Flexible spending or health savings account
  • Other additional voluntary benefits

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