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« Back to Search Sr. Workers' Compensation Claims Examiner - Fresno
Fresno, CA

Date Posted: April 22, 2019
Job Type: Direct Hire
Job ID: 344903

Job Description

The Senior Claims Adjuster responsible for the prompt and efficient examination, investigation and settlement of claims through effective research, negotiation and interaction with claimants and attorneys. The Claims Adjuster will be responsible for the understanding and knowledge of claims regulations.  

Responsibilities:

  • Regularly report on-site to client locations
  • Develop and maintain relationships with clients and their department heads
  • Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud and claim resolution
  • Complete quality investigations by gathering all pertinent information to include but not limited to investigation and medical records and data
  • Investigate new claims to determine compensability and subrogation possibilities, determine if subrogation exists and take steps necessary to initiate recovery efforts
  • Conduct a thorough analysis of liability and continually assess exposure and evaluate for accurate reserves
  • Calculate and provide disability benefits
  • Determine liability for permanent disability, mitigation of costs and resolution of claim
  • Oversee litigation and coordination of claims handling with defense team

Qualifications:

  • 5 years + handling California workers’ compensation claims
  • Current California Adjusters’ license
  • WCCA certification
  • Four year college degree in a related field is preferred
  • Ability to work under minimal supervision and primarily from a home office
  • Strong understanding of entire claims administration process
  • Demonstrated ability to manage relationships in a fast paced environment, while demonstrating persistence along with problem solving and decision making skills to work through a variety of challenging situations
  • Solid analytical abilities to review, exercise judgment and evaluate claims in order to make sound decisions
  • Ability to respond to requests effectively and efficiently
  • Strong knowledge of claim procedures, policies, technology, state laws and regulations
  • Proficient in communicating effectively and clearly, both orally and in writing
  • Capable of carrying out detailed written or verbal instructions
  • Ability to work independently with self-initiative
  • Excellent time management skills, organizational skills and ability to prioritize issues and tasks and handle large volumes of work in a short period of time
  • Competent in operation of computer equipment and applications

Why Insurance Relief™?
As a businessperson in the insurance industry, it is an advantage to partner with a staffing expert and ally who understands your unique skills and needs. With vast experience in the insurance arena, Insurance Relief™ works with brokers, carriers and third party administrators to locate and place the best people for positions ranging from entry level to senior management. We invest the time to truly understand what you want to accomplish, and then do our best to find meaningful opportunities.

Insurance Relief™ provides ample opportunities for you to put your skills to work so if this position is not quite the fit for you please give us a call to hear about all of the other opportunities we have available.

Contact us today! All Inquiries are kept confidential.
info@insurance-relief.com, 888-292-4440