Workers Comp. Sr. Claims Exami

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Workers Comp. Sr. Claims Examiner This is an advanced Claims Examiner position. Under the general supervision of the Workers' Compensation Manager and Claims Supervisor, this position is responsible for the investigation, evaluation, and settlement of claims. Principal Job Duties In accordance with claims management procedures, review, investigate, and manage workers' compensation claims for member school districts with use of a computerized claims management system. Obtain all documentation to substantiate the facts surrounding a claim. Evaluate and analyze the extent of exposure to accurately reserve claims. Analyze, make recommendations, and approve medical treatment plans from treating physicians and providers. Administer claim settlement authority according to policy. Administer statutory benefits to injured workers. Identify and pursue potential subrogation. Identify excess insurance claims, prepare reports to excess insurance carriers, and process reimbursements. Prepare concise reports for attorneys, physicians, member districts, and management. Provide status update to management on complex and/or sensitive claims. Develop and conduct periodic file reviews with member districts. Prepare claims for defense, settlement, subrogation, or arbitration activity. Provide direction to defense counsel, investigators, and vendors. Monitor and control claims costs. Delegate non-essential and/or clerical work to Claims Assistants and clerical support staff. Represent RESIG in hearings, settlement conferences, and trials. Develop and implement strategy to manage claims to an accurate and timely conclusion. Provide backup to Claims Examiners in their absence. Set and/or adjust schedule as needed for meetings, trainings, conferences, and work­related events. Performs other duties as assigned. Knowledge and Skills Workers' Compensation claim adjusting, investigation, and administrative techniques necessary to manage claims from initial report of injury to settlement or closure. California Labor Code, Government Code, and Education Code sections relative to workers' compensation benefits. Reserving practices and techniques in accordance with laws sufficient to establish and maintain adequate financial levels on all claims, with
Workers Comp. Sr. Claims Examiner This is an advanced Claims Examiner position. Under the general supervision of the Workers' Compensation Manager and Claims Supervisor, this position is responsible for the investigation, evaluation, and settlement of claims. Principal Job Duties In accordance with claims management procedures, review, investigate, and manage workers' compensation claims for member school districts with use of a computerized claims management system. Obtain all documentation to substantiate the facts surrounding a claim. Evaluate and analyze the extent of exposure to accurately reserve claims. Analyze, make recommendations, and approve medical treatment plans from treating physicians and providers. Administer claim settlement authority according to policy. Administer statutory benefits to injured workers. Identify and pursue potential subrogation. Identify excess insurance claims, prepare reports to excess insurance carriers, and process reimbursements. Prepare concise reports for attorneys, physicians, member districts, and management. Provide status update to management on complex and/or sensitive claims. Develop and conduct periodic file reviews with member districts. Prepare claims for defense, settlement, subrogation, or arbitration activity. Provide direction to defense counsel, investigators, and vendors. Monitor and control claims costs. Delegate non-essential and/or clerical work to Claims Assistants and clerical support staff. Represent RESIG in hearings, settlement conferences, and trials. Develop and implement strategy to manage claims to an accurate and timely conclusion. Provide backup to Claims Examiners in their absence. Set and/or adjust schedule as needed for meetings, trainings, conferences, and work­related events. Performs other duties as assigned. Knowledge and Skills Workers' Compensation claim adjusting, investigation, and administrative techniques necessary to manage claims from initial report of injury to settlement or closure. California Labor Code, Government Code, and Education Code sections relative to workers' compensation benefits. Reserving practices and techniques in accordance with laws sufficient to establish and maintain adequate financial levels on all claims, with
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