Tech Providers,

Claim Examiner- WC

7 days ago

PayCompetitive
LocationBrea/California
Employment typeOther

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  • Job Description

      Req#: 25-03740
      Position- Claim Examiner- WC
      Location- Remote
      Duration- 06 Months contract (High Possibility to extend)

      Note : Required WC experience for California 1-3 years of experience

      Duties:
      • Receives claim assignment, confirms policy coverages, and directs acknowledgement of claims.
      • Interprets and makes decisions using independent judgment on moderate difficulty claims and policy coverages and determines if coverages apply to claims submitted.
      • Investigates, evaluates, negotiates, and adjudicates first and third-party claims to determine validity and verify extent of damage by telephone contact with clients, claimants, witnesses or other parties as required.
      • Analyses 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.
      • Make settlement decisions 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.
      • Analyses 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.
      • Good verbal or written communication
      • Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action.
  • About the company

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