Sr Claim Examiner- WC - Abacus Service Corporation
Hauppauge, NY 11788
About the Job
Department:
02329 | SRMS | R0045 | BUS : RM New York - 02329
Job Category:
Claims
Job Code:
Sr Claim Examiner- WC:BS0160
Job Title:
Sr Claim Examiner- WC
Keywords:
Number of Positions:
1
Remaining Positions:
1
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:
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