Claims Examiner - Workers Compensation (Hourly)
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At a glance
Requirements
Credentials this posting asks for.
Job overview
ICONMA, LLC is hiring a Claims Examiner - Workers Compensation (Hourly). The Claims Examiner will analyze and process complex workers' compensation claims, investigating and gathering information to determine exposure. This role involves negotiating settlements, calculating and assigning reserves, and managing litigation to ensure timely and cost-effective resolution. The examiner will also communicate claim activity with clients and ensure proper documentation and coding.
Key focus areas include Analyze and process complex or technically difficult workers' compensation claims., Investigate and gather information to determine exposure on claims., and Manage claims through well-developed action plans to appropriate and timely resolution..
Important skills include Claims Analysis, Negotiation, Litigation Management, Cost Containment Techniques, Claim Recoveries, and Professional Client Relationships.
Skills & qualifications
Skills
Qualifications
Benefits
Full job description
Our Client, a Business Solutions company, is looking for a Claims Examiner - Workers Compensation (Hourly) for their Brea, CA location. Responsibilities:
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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.
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Negotiates settlement of claims within designated authority.
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Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
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Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
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Prepares necessary state fillings within statutory limits.
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Manages the litigation process; ensures timely and cost effective claims resolution.
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Coordinates vendor referrals for additional investigation and/or litigation management.
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Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
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Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
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Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
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Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
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Ensures claim files are properly documented and claims coding is correct.
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Refers cases as appropriate to supervisor and management.
Requirements:
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Bachelor's degree from an accredited college or university preferred.
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Professional certification as applicable to line of business preferred.
Why Should You Apply?
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Health Benefits
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Referral Program
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Excellent growth and advancement opportunities
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