Sr Claim Examiner- WC

Paladin Consulting, Inc.

  • Folsom, CA
  • 2 days ago
  • $36.59 Per Hour
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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

Description

Duties:
  • 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:
  • Claims 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

Numbers & Facts

LocationFolsom, CA
Salary$36.59 Per Hour

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