Sr Claim Examiner- WC at TPI (Tech Providers, Inc.)

Please see below job details:

Position Title: Sr Claim Examiner- WC
Location: 100% Remote
Expected Duration of Project: 3+ month contract

Job number : 33897371
 

Requires WC CA license.

Job Responsibilities:

• 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.

Requires Skills:

• Technical claims investigations/settling experience with 4-8 years of experience in Claims or similar organization.
• Workers Compensation (WC) Adjuster License required according to jurisdictional requirements.
• 3-5 years minimal experience specifically in Worker’s Compensation specifically WC designation is a bonus Great communication skills Experience with claim reviews and comfortable with presenting to clients.
• Requires CA license.

Preferred:

• Industry designations such as IIA, AIC, AEI and/or CPCU Would also like someone to be bilingual. Speaking, reading Spanish Hybrid Role
• Experience with Carrier Report Must have a CA License - WCCP; WCA and Self-Insured certification.