Offer summary

Qualifications:

Bachelor's degree or equivalent experience required., 4-8 years of experience in claims or a similar organization., Workers Compensation (WC) Adjuster License required according to jurisdictional requirements., Strong written and oral communication, negotiation, and presentation skills. .

Key responsabilities:

Interprets and makes decisions on complex policy coverages for claims submitted.

Manages investigative activities and directs litigation strategy with legal counsel.

Analyzes claims activity and prepares reports for clients, carriers, and management.

Establishes reserves and authorizes payments within scope of authority, ensuring timely disbursements.

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Job description

Sr Claim Examiner- WC
2+ Months

100% REMOTE

Must have experience adjusting Ohio self insured client claims

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.

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.

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

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