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.
PA/DE/MD/VA/DC
· Preferred:
Industry designations such as IIA, AIC, AEI and/or CPCU
Numbers & Facts
Location
Brea, CA (Remote)
Salary
$37.27 Per Hour
Skills
Analysis Skillsunmatched
Claims Processingunmatched
Disbursementsunmatched
Establish Prioritiesunmatched
Institute of Internal Auditors (IIA)unmatched
Legalunmatched
Litigationunmatched
Multitaskingunmatched
Negotiation Skillsunmatched
Presentation/Verbal Skillsunmatched
Problem Solving Skillsunmatched
Reporting Skillsunmatched
Subrogationunmatched
Time Managementunmatched
Worker's Compensationunmatched
Writing Skillsunmatched
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