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Sr Claim Examiner- WC

Brea, CA

Posted: 12/05/2024 Job Number: 24345776

Job Description

Position- Sr Claim Examiner- WC
Location- Remote
Duration- 03 Months contract (High Possibility to extend)
 
Duties:
  • Receives claim assignment, confirms policy coverages, and directs acknowledgement 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.
  • Analyses 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.
  • Analyses claims activities and prepares reports for clients, carriers, and/or management. Participates in claim reviews.
 
Skills:
  • Ability to work independently while assimilating various technical subjects.
  • Good verbal or written communication
  • Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action.

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About Brea, CA

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