Broadspire · 1 day ago
Senior Claim Examiner - Workers Compensation (CA)
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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.
Qualification
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Required
Bachelor’s degree or equivalent experience required.
Workers Compensation (WC) Adjuster License required according to jurisdictional requirements
Technical claims investigations/settling experience with 4-8 years experience in Claims or similar organization.
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.
Effective advanced interpersonal skills to effectively interact with all levels of internal and external clients.
Preferred
IIA, AIC, AEI, and/or CPCU Designations
Benefits
Bonus Opportunities
Multiple Employee Discounts
Benefit programs that empower financial, physical, and mental wellness
Training programs that promote continuous learning and career progression while enhancing job performance
Sustainability programs that give back to the communities in which we live and work
Company
Broadspire
Broadspire is an insurance company that provides claims management solutions.