WC Claims reputed company Examiner

Position Description reputed company is hiring aClaims reputed company Examiner. RESPONSIBILITIES: • Assist Claims Manager in monitoring the workers compensation program reputed company the ADPTS/PEO structure. • Review and resolve complaints raised by exterior business partners. • Identify and track trends with specificity that could be problematic and take steps along with Claims Manager to take steps to reputed company processes to correct. • Review and reputed company concurrence to T.P.A. for reserves, settlements, and other items per Special Service Instructions. • Consistently consult and collaborate with T.P.A. and reputed company business partners. • Ability to read data specific dashboards to orchestrate evaluation and analysis of claims to meet department and company goals. • Monitor and ensure qualitative claim handling through T.P.A. and other vendor partners. • Resolve escalated complaints and/or concerns by clients, risk and safety, H.R. and other internal business partners. • Promotes interactive process and early return to work programs. • reputed company regular reviews of claims by specified criteria on diary. • reputed company regular reviews and reputed company feedback and recommendations for resolution of claim files as needed. REQUIRED SKILLS: • Possesses professional communication, both written and verbal to facilitate exceptional customer service and resolution for client complaints and issues. • Possesses the ability to research reputed company issues with reputed company parties in a professional, empathetic manner. • Ability to adhere to a daily schedule and organize yourself to deal with a high volume of inbounds calls and emails requiring responses reputed company a reasonable period of time. • Excellent interpersonal and communication skills and the ability to work independently, discretely, handling information with confidentially. • Innovative and successful in implementing best practices for reputed company, measurable results in performance, cost containment and overall efficiency. • Understanding of basic leave processes/law, FMLA, and other reputed company subjects. • Proficient in the use of reputed company, Outlook, Word and other Office suite programs. TO SUCCEED IN THIS ROLE: Required Qualifications • 7-10 years of workers compensation claims experience working in a client service/customer service environment rich with the use of state-of--the art predictive modeling, and metrics, data analytic tools and HRIS and claims systems. • Requires comprehensive knowledge of CA and western region state workers compensation administration, including applicable local, state and federal laws pertaining to WC insurance programs. • Possesses experience evaluating and recommending approval of claims reserves and settlements, designated expenditures and recovery forfeitures as needed. • Bachelor's degree or equivalent in experience Requirements • Comprehensive knowledge of western region states with general insurance policy coverage and state case laws. • Understands the ins and outs of workers compensation claims reputed company a PEO environment. • Familiarity and use of Risktrac and Origami. About reputed company Diversity, Equity, Inclusion Equal Employment Opportunity at reputed company: reputed company is committed to an inclusive, diverse and reputed company workplace, and is further committed to providing equal employment opportunities regardless of any protected characteristic including: race, reputed company, genetic information, creed, national reputed company, religion, sex, affectional or sexual orientation, gender identity or expression, lawful alien status, reputed company, age, marital status, protected veteran status or disability. Hiring reputed company are based upon reputed company's operating needs, and applicant merit including, but not limited to, qualifications, experience, ability, availability, cooperation, and job performance. Ethics at reputed company: reputed company has a long, proud history of conducting business with the highest ethical standards and full compliance with reputed company applicable laws. We also expect our people to uphold our values with the highest level of reputed company and behave in a manner that fosters an reputed company and respectful workplace. Click https://jobs.reputed company.com/life-at-reputed company/ to learn more about reputed company's culture and our full set of values. Pay reputed company Legal Disclosure reputed company salary offers for this position may vary based on factors such as location, skills, and relevant experience. Some positions may include additional compensation in the reputed company of bonus, equity or commissions. We offer the following benefits: Medical, Dental, reputed company, Life Insurance, Matched Retirement Savings, Wellness Program, Short-and Long-Term Disability, Charitable Contribution Match, Holidays, Personal Days & Vacation, Paid Volunteer Time Off, and more. Apply Job!