Associate Claims Examiner

Markel•Henderson, NV

20h•Onsite

About The Position

This position will be responsible for the resolution of low complexity and low exposure claims and provide support to other team members as directed. This position will work closely with their manager to train and develop fundamental claims handling skills. The role involves investigating moderate to complex claims as reported and determining injured worker’s eligibility for workers’ compensation benefits. It also includes administering indemnity and medical benefits for valid workers’ compensation claims and managing the progression of the claims process through collaboration with physicians, nurses, attorneys, and other parties as needed. The examiner will also determine if subrogation exists and take necessary steps to initiate recovery efforts. All file handling must be within state statutes, client claims handling guidelines, and best practices.

Requirements

Must have or be willing to obtain CA claims handling certification
Must be certified to handle medical only claims in the state of CA
Prior experience handling California workers’ compensation claims is required
Experience handling CA claims is required
Must be able to obtain/maintain the required CA CEU hours to adjust CA claims
Excellent written and oral communication skills
Strong analytical and problem solving skills
Strong organization and time management skills
Ability to deliver outstanding customer service
Intermediate skills in Microsoft Office products (Excel, Outlook, Power Point, Word)
Ability to work in a team environment
Strong desire for continuous improvement
US Work Authorization required

Nice To Haves

Experience handling workers’ compensation claims across multiple jurisdictions is a plus
Experience handling AZ/CO/UT claims is a plus
A degree in business related courses optional in exchange for experience in insurance
An insurance designation is a plus
Strong knowledge and understanding of medical terminology is a plus

Responsibilities

Resolution of low complexity and low exposure claims
Provide support to other team members as directed
Work closely with their manager to train and develop fundamental claims handling skills
Investigate moderate to complex claims as reported and determine injured worker’s eligibility for workers’ compensation benefits
Administer indemnity and medical benefits for valid workers’ compensation claims
Manage the progression of the claims process through collaboration with physicians, nurses, attorneys and other parties as needed
Determine if subrogation exists and takes the steps necessary to initiate recovery efforts
Ensure all file handling is within state statutes, client claims handling guidelines, and best practices