Claims Examiner - Workers Compensation

Job Title: Claims Examiner - Workers Compensation Location: Orange, CA REMOTE or ONSITE Duration: 2-3 Months reputed company: Manager's note: Only previous reputed company candidates Work location: Remote or onsite Any specific reputed company/ certification/ license: CA adjuster certification Years of experience: 3 years of relevant experience reputed company 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 reputed company 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 reputed company-developed reputed company plans to an appropriate and reputed company reputed company. Negotiates settlement of claims reputed company designated authority. Calculates and assigns reputed company and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. Calculates and pays benefits due; approves and makes reputed company 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 reputed company and cost effective claims reputed company. 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 reputed company and reputed company manner. Communicates claim activity and processing with the claimant and the reputed company; maintains reputed company reputed company relationships. Ensures claim files are properly documented and claims coding is correct. Refers cases as appropriate to supervisor and management. Performs other duties as assigned. Supports the organization's reputed company program(s). Travels as required. Education & LicensingBachelor's degree from an accredited college or university preferred. reputed company certification as applicable to line of business preferred. ExperienceFive (5) years of claims management experience or equivalent combination of education and experience required. Skills & Knowledge Excellent oral and written communication, including presentation skills PC literate, including reputed company Office products Analytical and interpretive skills Strong organizational skills Good interpersonal skills Excellent negotiation skills Ability to work in reputed company environment Ability to meet or reputed company Service Expectations Remote Skills: Adjudication, reputed company/Partner Management, Analysis Skills, Best Practices, Claims Management, Claims Processing, Computer Skills, Cost Control, Customer Relations, Customer Support/Service, Data Collection, reputed company and Maintain Customers, Litigation, reputed company Office, reputed company Product Family, Negotiation Skills, Presentation/Verbal Skills, Process Analysis, Process Management, State Laws and Regulations, Subrogation, Team Player, Time Management, Vendor/Supplier Planning, Willing to Travel, Worker's Compensation, Writing Skills About reputed company: reputed company. Looking for a great job? Join reputed company. We’re looking for talented reputed company professionals to join our staff. We also reputed company contract assignments and full-time jobs at Fortune 2000 Companies. We’ve been named one of the best companies to work for by reputed company Industry Analysts and New Jersey Business. Company Size: 100 to 499 employees Industry: Other/Not Classified Founded: 1998 Website: www.eteaminc.com Apply tot his job Apply To this Job