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Claim Examiner- WC

Brea, CA

Posted: 11/01/2023 Job Number: 20776521

Job Description

Claim Examiner- WC
Location –Brea, CA
Duration: 06+ month contract with possible extension and conversion 
Job Roles
  • Receives claim assignment, confirms policy coverages, and directs acknowledgment of claims.
  • Interprets and makes decisions using independent judgment on moderate difficulty claims and policy coverages and determines if coverages apply to claims submitted.
  • Investigates, evaluates, negotiates and adjudicates first and third-party claims to determine validity and verify extent of damage by telephone contact with clients, claimants, witnesses or other parties as required.
  • 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.
  • Make settlement decisions 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. 
Skills Required
  • Bachelor's degree or equivalent experience required.
  • Comprehensive claims investigations/settling experience 1-3 years’experience in Claims or similar organization

Meet Your Recruiter

Rishab Choudhary

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