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Hornet Staffing, Inc.

Sr Claim Examiner- WC

Hornet Staffing, Inc., Portland, OR, United States


Description:
  • 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.
Skills:
  • 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.
Education:
  • 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
Skills: Required
  • PRESENTATION SKILLS
  • PROBLEM SOLVING
  • CLAIMS
  • TECHNICAL CLAIMS
Additional
  • LITIGATION STRATEGY
  • PAYMENTS