I'm working on a Senior Claims Examiner position. The role will be tasked to independently investigate, evaluate, negotiate, settle and adjust claims in accordance with state law and internal guidelines.
Duties and Responsibilities:
Independently investigate assigned claims, following sound claims handling techniques in accordance with company claim philosophy and standards.
Collaborate with unit supervisor, review all relevant data, evaluate claims, determine coverage and exposure and negotiate within settlement authority.
Document files with necessary reports, investigative notes, and other data as may be required by the company and the unit supervisor. Keep unit supervisor advised on status of problem claims.
Prepare files for hearing, develops defense of issues, identify witnesses and make decisions regarding appeals.
Attend hearings, mediations, settlement conferences, pre-trial hearings and fraud trials.
Manage personal caseload effectively in accordance with claims standards.
Skills, Education and Experience:
Bachelor's degree and 4-7 years of claims adjusting experience or 10 years equivalent work experience including 5 years of workers compensation claims adjusting and AIC designation or comparable designation.
Ability to evaluate lost time cases of 6 months or greater, negotiate permanent disability cases, manage litigated cases, provide guidance and interpretation of WC laws, and serve as a mentor for claims adjusters.
Basic keyboarding and math skills.
Must be a detail-oriented, flexible self-starter, with excellent written and verbal communication skills, capable of handling multiple tasks in a challenging environment.
Eames Consulting is acting as an Employment Agency in relation to this vacancy.
