Sr Claim Examiner- WC
Location: REMOTE
Duration: 4 months plus extensions
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
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