Berkley

Claims Examiner

Location Name CA, Walnut Creek
ID
2021-4590
Date Posted
1 day ago(3/5/2021 10:23 AM)
Company
Preferred Employers Insurance
Primary Location
US-CA-Walnut Creek
Loc2
CA, San Diego - 9797 Aero Drive
Category
Claims

Company Details

Preferred_Employers_Insurance_Logo

 

Preferred Employers Insurance Company began operations in San Diego, California in 1998. The company provides workers’ compensation insurance for a wide variety of industries. Our goal is to provide our customers with a stable and reliable workers’ compensation insurance product regardless of market cycles. We are dedicated to being the preferred workers’ compensation insurance solution for California businesses.

Responsibilities

Our Claims Examiners conduct the handling of claims in the utmost of good faith in compliance with the rules, regulations and statutes of the WCAB and State of California. We function with a high degree of competency and sound judgment, coupled with consistent results!

 

Responsibilities for this opportunity include: 

  • Analyzing and processing workers’ compensation claims by investigating and gathering information to determine the exposure on the claim.
  • Negotiating the settlement of claims up to designated authority level and making claims payments.
  • Calculating and assigning timely and appropriate reserves to claims and continuing to manage reserve adequacy throughout the life of the claim.
  • Calculating and paying benefits due; approving all claim payments; and settling claims within designated authority level.
  • Developing and managing claims through well-developed action plans; continuing to work the action plan to bring the claim to an appropriate and timely resolution.
  • Preparing necessary state filings within statutory limits.
  • Actively managing the litigation process; ensuring timely and cost effective claims resolution.
  • Coordinating vendor referrals for additional investigation and/or litigation management.
  • Using appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims.
  • Managing claim recoveries of all types, including but not limited to subrogation, Second Injury Fund recoveries, and Social Security offsets.
  • Reporting claims to the excess carrier, responds to requests of directions in a professional and timely manner.
  • Frequently communicating with all appropriate parties involved with the claim.
  • Referring cases as appropriate to management.
  • Maintaining professional client relationships.
  • Actively executing appropriate claims activities to ensure consistent delivery of quality claims service.

Qualifications

Our ideal candidate will have the following:

  • 3+ year claims management experience in workers’ compensation
  • Bilingual in Spanish/English a plus
  • Knowledge of appropriate insurance principles and laws for workers’ compensation
  • Strong written and verbal communication skills
  • Strong organizational skills
  • Strong negotiation skills
  • Strong analytical and interpretive skills
  • PC literate
  • Baccalaureate degree from an accredited college or university preferred
  • Professional certification as applicable to workers’ compensation required

This role may be located in San Diego or Walnut Creek.

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