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Sr Claim Examiner- WC

Key Facts

Remote From: 
Fixed term
Senior (5-10 years)
French

Other Skills

  • β€’
    Decision Making
  • β€’
    Negotiation
  • β€’
    Analytical Skills
  • β€’
    Problem Reporting
  • β€’
    Communication
  • β€’
    Problem Solving
  • β€’
    Teamwork

Roles & Responsibilities

  • Bachelor's degree or equivalent experience
  • 4-8 years experience in Claims or similar organization
  • Workers Compensation (WC) Adjuster License required
  • Industry designations such as IIA, AIC, AEI and/or CPCU (preferred)

Requirements:

  • Interprets and makes decisions on complex policy coverages
  • Manages investigative activities on complex claims
  • Analyzes claims activity and prepares reports for clients/carriers
  • Establishes reserves, authorizes payments, and settles claims

Job description

Job Title: Sr Claim Examiner- WC
Location: REMOTE
Duration: 3 months plus extensions 
 
Job Description
  • 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 year’s 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

Why TalentBurst?
At TalentBurst, we deliver more than talent, we deliver outcomes. We partner with you to move quickly and connect you to opportunities aligned with your skills and long term growth.

Backed by precision, transparency, and results, we connect top talent with leading organizations through trusted partnerships.

We offer competitive compensation and comprehensive benefits, including medical, dental, vision, and retirement options.

TalentBurst is an equal opportunity employer committed to an inclusive and diverse workforce.

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