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CLAIMS EXAMINER - Workers Compensation (with TPA experience)

San Diego, CA

Post Date: 06/29/2017 Job ID: 15063 Industry: Insurance

WORKERS COMPENSATION CLAIMS EXAMINER needed for office located in Escondido. The qualified candidate must have recent experience working as a workers compensation adjuster as well as experience working for a TPA in a WC role. The qualified candidate will also be self insured; SIA or SIP.

Job duties will include, but are not limited to: 
  • Analyze and manage claims by investigating and gathering information to determine the exposure on the claim.
  • Manage claims through action plans to an appropriate and timely resolution.
  • Communicate claim activity and processing with the claimant and the client.
  • Negotiate settlement of claims within designated authority.
  • Calculate and assign reserves to claims.
  • Ensure claim files are properly documented and coding is correct.
  • Calculate and pay benefits; approve and make timely claim payments and adjustments. Settle claims within designated authority level.
  • Maintain professional client relationships.
  • Other duties as required.

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- Hourly pay depends on experience; $28/hr. - $35/hr. 

- Position is Temp-to-Hire OR Direct Hire

- Full time hours.

- Regular and Prompt attendance is mandatory for this job

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