Claims Examiner I Workers Compensation I CA experience
About The Position
The Claims Examiner I analyzes workers compensation claims on behalf of clients to determine benefits due, while ensuring claims are adjudicated in accordance with service expectations, industry best practices, and client-specific requirements. The role investigates claims, gathers information to assess exposure, develops action plans for timely resolution, negotiates settlements within designated authority, communicates claim activity to claimants and clients, and reports claims to excess carriers while responding to direction requests. The position requires California jurisdiction knowledge and five years of claims management experience or an equivalent combination of education and experience.
Requirements
- Five years of claims management experience or an equivalent combination of education and experience.
- High school diploma or GED.
- California licensing/jurisdiction knowledge.
- Ability to use a computer keyboard.
- Hearing, vision, and talking abilities.
- Clear and conceptual thinking, excellent judgment and discretion, and the ability to meet deadlines.
Nice To Haves
- Bachelor's degree from an accredited college or university.
- Professional certification applicable to the line of business.
Responsibilities
- Analyze and process claims through well-developed action plans to achieve appropriate and timely resolution.
- Investigate claims and gather information to determine claim exposure.
- Negotiate claim settlements within designated authority.
- Communicate claim activity and processing with claimants and clients.
- Report claims to the excess carrier and respond to requests for directions professionally and in a timely manner.
Benefits
- Flexible work schedule.
- Referral incentive program.
- Opportunity to work in an agile environment.
- Career development and promotional growth opportunities.
- Medical, dental, and vision coverage.
- 401(k) and matching.
- Paid time off (PTO).
- Disability and life insurance.
- Employee assistance program.
- Flexible spending account or health savings account.
- Additional voluntary benefits.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
