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Sr Claim Examiner- WC

Folsom, CA

Posted: 08/02/2022 Job Number: 17449919

Job Description

Position: Sr Claim Examiner- WC
Location: Folsom, CA
Duration: 3 + Months of contract
  • 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.
  • 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.
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

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Sandhya Rai

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