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Claims Examiner-WC 

resume-library  |  United States  |  

United StatesUnited States (US)
Banking & Insurance/Insurance
Work Type:
Work Time:
Full Time


Claims Examiner-WC

Remote anywhere

Experience handling Arizona Workers Comp Claims

Comprehensive claims investigations/settling experience 1-3 years experience in Workers Comp Claims



Receives claim assignment, confirms policy coverages and directs acknowledgement of claims. - Interprets and makes decisions using independent judgment on moderate difficulty claims and policy coverages and determines if coverages apply to claims submitted. - Investigates, evaluates, negotiates and adjudicates first and third party claims to determine validity and verify extent of damage by telephone contact with clients, claimants, witnesses or other parties as required.    - Analyzes claims activity and prepares reports for clients/carriers and management. - Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements. - Make settlement decisions promptly and equitably and issues company drafts in payments for claims within authority limits. - Develops subrogation and third party recovery potential and follows reclaim procedures. - Analyzes claims activities and prepares reports for clients, carriers and/or management. Participates in claim reviews.  


Ability to work independently while assimilating various technical subjects. - Good verbal or written communication skills. - Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action. - Strong ability to identify, analyze and solve problems. - Effective interpersonal skills to be capable of dealing with external sources and all levels of employees.  


Bachelor's degree or equivalent experience required. - Comprehensive claims investigations/settling experience 1-3 years experience in Workers Comp Claims or similar organization