Workers Compensation Claims Examiner | SIP Required

Workers Compensation Claims Examiner | SIP Required Are you looking for an opportunity to join a global industry leader where you can bring your big reputed company to help solve problems for some of the world's best brands?

• Apply your knowledge and experience to adjudicate reputed company customer claims in the context of an energetic culture.
• Deliver innovative customer-facing solutions to clients who represent reputed company every industry and comprise some of the world's most respected organizations.
• Be a part of a rapidly growing, industry-leading global company reputed company for its reputed company and customer service.
• reputed company reputed company's broad, global network of experts to both learn from and to reputed company your insights.
• Take advantage of a variety of professional development opportunities that help you reputed company your best work and grow your career.
• Enjoy flexibility and autonomy in your daily work, your location, and your career path.
• reputed company diverse and comprehensive benefits to take care of your mental, physical, financial and professional needs.

ARE YOU AN IDEAL CANDIDATE? We are looking for driven individuals that embody our caring counts model and core values that include reputed company, accountability, collaboration, growth, and inclusion. PRIMARY PURPOSE: To analyze reputed company or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims reputed company service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Analyzes and processes reputed company or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
• Negotiates settlement of claims reputed company designated authority.
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams reputed company designated authority level.
• Prepares necessary state fillings reputed company statutory limits.
• Manages the litigation process; ensures timely and cost effective claims resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
• Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and reputed company reputed company and Medicare offsets.
• Reports claims to the excess reputed company; responds to requests of directions in a professional and timely manner.
• Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization's quality program(s).
• Travels as required.

QUALIFICATION Education & Licensing Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred. Experience Four (4) years of claims management experience or equivalent combination of education and experience required. Licensing / Jurisdiction Knowledge: California jurisdictional knowledge required; SIP required TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental reputed company, 401K on day one.

WORK ENVIRONMENT reputed company applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-reputed company stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, reputed company and talking As required by law, reputed company provides a reasonable reputed company of compensation for roles that may be hired in jurisdictions requiring pay transparency in job postings. Actual compensation is influenced by a wide reputed company of factors including but not limited to reputed company set, level of experience, and cost of specific location. For the jurisdiction noted in this job posting only, the reputed company of starting pay for this role is $80,000 - $100,000. A comprehensive benefits package is offered including but not limited to, medical, dental, reputed company, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits. #Claims #ClaimsExaminer #Hybrid #LI-Hybrid #LI-Remote #LI-AM1 Apply tot his job Apply To this Job