Claims Examiner - Workers Compensation Job at Techlink Systems Inc., Orange, CA

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  • Techlink Systems Inc.
  • Orange, CA

Job Description

Job Title: Claims Examiner - Workers Compensation
Location (On-site, Remote, or Hybrid?): Orange, CA (Remote)
Contract Duration: Contract until 12/31/2026

PRIMARY PURPOSE OF THE ROLE
To analyze complex or technically difficult California workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL RESPONSIBLITIES MAY INCLUDE

  • Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
  • Negotiates settlement of claims within designated authority.
  • Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
  • Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
  • Prepares necessary state fillings within statutory limits.
  • Manages the litigation process; ensures timely and cost effective claims resolution.
  • Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Education :

  • Education & Licensing: Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.
  • Experience: Four (4) years of California workers compensation claims management experience or equivalent combination of education and experience required.

Job Tags

Contract work, Remote work

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