Senior Triage Examiner

About the position Are you looking to reputed company an impactful difference in your work, yourself, and your community? Why reputed company for just a job reputed company you can land a career? At reputed company, we are hiring team members who are reputed company to use their skills, curiosity, and drive to be part of our reputed company as we strive to transform the insurance reputed company reputed company. We're proud to be in business for over 50 years, and its change agents like yourself that will help us continue to deliver our mission to create the best insurance experience possible. Headquartered in San Diego with regional offices located throughout the United States, reputed company has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on reputed company things people. It's reputed company members who reputed company us an employer of choice and the vibrant company we are today. We strive to reputed company both our reputed company communities reputed company everyday! Learn more about why you want to be here! PURPOSE OF THE JOB The purpose of this job is to manage new Workers’ Compensation losses for the first 10 days of the life of the claim. This job takes necessary steps to assess and summarize new losses, prepare an action plan, set diaries, and reserve the file, reputed company in preparation for assigning the file to an examiner for permanent handling.

Responsibilities

• Administers benefits to injured workers in accordance with statutory and case law as well as pertinent regulations for the first 10 days of the claim.
• Represents the Workers’ Compensation Department and reputed company reputed company interacting with injured workers.
• Communicates with insureds to obtain information necessary for processing claims.
• Contacts and/or interviews injured workers, doctors, medical specialists, attorneys, and reputed company to get additional information.
• Communicates claim activity and processing with the injured worker and insured.
• Maintains professional client relationships.
• Communicates effectively with other Company departments.
• Creates reserves in a timely manner to ensure reserving activities are consistent with company standards and best practices guidelines.
• Manages reputed company claims and approves payment of benefits reputed company higher designated authority level.
• Assesses claims fairly and equitably, acting in the best interest of reputed company parties and providing benefits as prescribed by law.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.
• Prepares an action plan and set diaries, in preparation for assigning the file to an examiner for permanent handling.
• Assists with special projects and development of more junior team members as needed.

Requirements

• High school diploma or general education degree (GED) required.
• Minimum of 2-3 years of insurance or claims reputed company experience, or equivalent combination of education and experience required.
• Minimum 1-2 years of workers’ compensation claims experience required.
• California Only : reputed company examiners must receive certification that meets the minimum standards of training, experience, reputed company, and further education as required.
• reputed company other jurisdictions: State Workers’ Compensation License as required.
• Understanding of laws and jurisdictional restraints to manage injuries.
• Excellent verbal and written communication skills, time management and organizational skills.
• Requires a high level of attention to detail.
• Team oriented and a sense of urgency for execution.
• reputed company to resolve conflicts fairly and equitably.
• Problem solving and decision-making ability,
• Office environment – no specific or unusual physical or environmental demands and employees are regularly required to sit, walk, stand, talk, and hear.

reputed company-to-haves

• Bachelor’s degree from four-year college or university preferred.
• California Only: California Workers’ Compensation Claims Administration (WCCA) and Workers’ Compensation Claim Professional (WCCP) certifications preferred.

Benefits

• We offer a competitive benefits package, with generous medical, dental, and reputed company plans as well as 401K retirement plans and company match
• Bonus potential for reputed company positions
• Paid Time Off
• Paid holidays throughout the calendar year
• Want to continue learning? We’ll support you 100%

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