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Sr Claim Examiner- WC

Folsom, CA

Posted: 08/10/2023 Job Number: 20301208

Job Description

Position: Sr Claim Examiner- WC
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.

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Pooja Yadav

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