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Company Preferred Employers Insurance
Location Name CA, San Diego - 9797 Aero Drive
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.
ID
2021-4702
Primary Location
US-CA-San Diego
Company Preferred Employers Insurance
Location Name CA, Walnut Creek
Preferred Employers Insurance is a member company of the W. R. Berkley Corporation, a Fortune 500 company rated A+ (Superior) by A.M. Best Company. Take your career to the next level and join us! Find out why we are the preferred workers’ compensation insurance solution for California employers.   We currently have a great opportunity for a Senior Workers’ Compensation Examiner to join our team!  Our Senior Examiners are responsible for the analysis and management of complex workers’ compensation claims. This position will review, investigate, and make decisions regarding coverage, compensability, and appropriateness of claims. The position will process and document claims to ensure compliance with company standards, industry best practices, and legislative provisions. Acts in a fiduciary role on behalf of policyholders, negotiates claim settlements and manages subrogation. Senior Claims Examiner’s 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. The Senior Workers’ Compensation Examiner is expected to function with a degree of competency. The use of sound judgment coupled with consistent results is expected.   Responsibilities include but are not limited to - Analyzes and processes workers’ compensation claims by investigating and gathering information to determine the exposure on the claim. - Negotiates settlement of claims up to designated authority level and makes claims payments. - Processes complex or technically difficult claims. - Calculates and assigns timely and appropriate reserves to claims and continues to manage reserve adequacy throughout the life of the claim. - Calculates and pays benefits due; approves all claim payments; and settles claims within designated authority level. - Develops and manages claims through well-developed action plans; continues to work the action plan to bring the claim to an appropriate and timely resolution. - Prepares necessary state filings within statutory limits. - Actively manages the litigation process; ensures timely and cost-effective claims resolution. - Coordinates vendor referrals for additional investigation and/or litigation management. - Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims. - Manages claim recoveries of all types, including but not limited to subrogation, Second Injury Fund recoveries, and Social Security offsets. - Reports claims to the excess carrier, responds to requests of directions in a professional and timely manner. - Frequently communicates with all appropriate parties involved with the claim. - Refers cases as appropriate to management. - Maintains professional client relationships. - Actively executes appropriate claims activities to ensure consistent delivery of quality claims service.
ID
2021-4695
Primary Location
US-CA-Walnut Creek
Loc2
CA, San Diego - 9797 Aero Drive
Company Preferred Employers Insurance
Location Name CA, San Diego - 9797 Aero Drive
The Senior Underwriter is primarily responsible for risk evaluation and pricing for new and existing business in accordance with the company’s underwriting approach and guidelines.  The Senior Underwriter develops and fosters positive, professional, and effective relationships with the company’s broker partners, as well as achieves company growth and profitability objectives.  This position is expected to exhibit a high level of technical expertise, while exercising sound judgment, and delivering consistent results. The Senior Underwriter is also expected to be a leader and role model within the department, helping to train and mentor less experienced staff.  The Senior Underwriter is expected to be solution oriented and exhibit a strong customer experience mindset.   Responsibilities include but are not limited to the following:   - Selects new business and evaluates renewal accounts in accordance with company underwriting philosophy and guidelines. - Works within established authority parameters and adheres to written/verbal processes and procedures. - Demonstrates a professional, courteous attitude with brokers and other company staff. Responds quickly and ethically to all requests/issues.  Assists in issue resolution and will coordinate with other departments when necessary. - Provides accurate and thorough guidance to brokers regarding the company’s appetite philosophy and pricing guidelines. - Monitors performance criteria, including premium and unit count goals, mix of business, production ratios for assigned brokers/product segments. - Achieves company growth objectives by recognizing sales opportunities, soliciting desirable business, supporting company rate strategy and diligent follow-up on quoted business. - Travels to brokers providing field underwriting and quoting as needed. - Reviews claims activity, loss control surveys, and inspection reports for existing policies, handling as required. - Collaborates with colleagues in Marketing/Sales to achieve shared objectives and execute company strategy. - Determines the appropriate course of action for policy changes, delegating as appropriate to processing assistants for handling. - Provides mentoring and training to less experienced staff members. - Embraces the importance of the customer experience and is execution oriented. - Uses an innovative mindset to improve the department function and achieve strategic objectives. - Handles other projects or initiatives as assigned
ID
2021-4655
Primary Location
US-CA-San Diego
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.
ID
2021-4590
Primary Location
US-CA-Walnut Creek
Loc2
CA, San Diego - 9797 Aero Drive

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