Sr Claim Examiner- WC
Folsom, CA US
Location: Folsom, CA 95630 (Onsite)
Duration: 04+ 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.
- 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.