TalentBurst
Sr Claim Examiner- WC
TalentBurst, Brea, CA, United States
33897371
Sr Claim Examiner- WC
Location : 675 Placentia Avenue, Suite 350, Brea CA 92821
Hybrid role & California required License and Spanish is a Plus ( Speak, Read )
Duration : 3 Months
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
Sr Claim Examiner- WC
Location : 675 Placentia Avenue, Suite 350, Brea CA 92821
Hybrid role & California required License and Spanish is a Plus ( Speak, Read )
Duration : 3 Months
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