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Company Preferred Employers Insurance
Location Name CA, Walnut Creek
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.
Primary Location
US-CA-Walnut Creek
Company Preferred Employers Insurance
Location Name CA, San Diego - 9797 Aero Drive
The Customer Service Representative is responsible for learning company policy and procedure in relation to policy administration and claims first notice of loss. This representative provides a high level of customer service and also provides general administrative support to other departments such as premium audit, premium accounting, and underwriting. The Customer Service Representative must exhibit a degree of competency, productivity, timeliness and accuracy, while exercising appropriate judgment and must also be a team player.   Responsibilities include but are not limited to: - Handle phone, email and live chat requests in a professional and courteous manner - Resolve insured, broker and claimant inquiries with exceptional customer service - Process premium audits & payments - Create payment histories - Assist callers with Company website and banking site login - Obtain necessary information to create a claim and perform data entry to setup new claims, create activity notes and search database for coverage - Send initial claim letters and forms to employers and injured workers - Collaborate with other team members when assistance is needed - Complete various related tasks and projects as assigned
Primary Location
US-CA-San Diego

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