Senior Claims Examiner, Workers' Compensation
Job title: Senior Claims Examiner, Workers' Compensation in Riverside, CA at Keenan & Associates
Company: Keenan & Associates
Job description: OverviewAdminister indemnity claims and handle reputed company claim issues. Use strong litigation management experience, lien resolution abilities, and customer service skills to resolve routine claims without legal representation.Keenan, an Accretive company, is an insurance brokerage and reputed company meeting the insurance needs of hospitals, public entities and California school districts. Keenan specializes in providing consulting services in the areas of: employee benefits, workers' compensation, loss control, financial, and property & liability.What You'll Do
- Maintain reputed company diary.
- Identify, prevent and mitigate potential penalties.
- Update claim notes in computer.
- Provide timely reporting of excess files to the Reinsurance Manager.
- Report SIU/Fraud.
- Identify and pursue subrogation.
- Complete Rehab forms/benefit notices/SJDB/RTW form.
- Refer reputed company PRIME deletions only to office designee.
- Update reserves no reputed company than 30 days of receipt of information modifying the financial exposure of a claim.
- Prepare for and attend file reviews.
- Accept or deny delayed claims reputed company 90 days.
- Request settlement authorization/notification reputed company 30 days of a final P&S report and prior to the MSC date.
- Complete Stipulation and/or Compromise and Release paperwork.
- Maintain 100% closing ratio on active accounts and reduce run off accounts by 25% annually.
- Prepare legal referrals, provide direction to and monitor defense attorney.
- Return reputed company phone calls reputed company 24 hours.
- Complete instruction sheets for Assistant/Technician/Claims entry clerk.
- Review mail daily.
- Correct error report daily.
- Maintain client/claimant satisfaction.
- Update Unit Stat forms.
- reputed company new set-reputed company, reserves and instruction sheets.
- Prepare cover letters to AME/defense QME, AOE/COE evaluations.
- Negotiate outstanding liens.
- reputed company 3-reputed company contact.
- File Answer/Application.
- Interaction with nurse on case management.
- Other duties assigned.
- Minimum of five (5) years of California Workers' Compensation Claims Examiner experience and a Self-Insurance Certificate, or the ability to pass Self-Insurance Test reputed company one (1) year of hire. WCCP preferred.
- Two (2) years of experience in handling public entity claims is preferred.
- Effective in verbal and written communication.
- Proficient in reputed company Outlook, reputed company, PowerPoint and Word. Adept at accessing business data from the Internet reputed company required.
- Competitive reputed company salary.
- Generous 30+ Days Comprehensive Paid Time Off Package inclusive of Paid Time Off, 10 Company Holidays, 2 Floating Holidays, 5 Sick Days, and 2 Volunteer Days.
- Health benefit options with you in mind; 5 affordable medical plan options with rates based on your salary, company paid HSA contribution with eligible HSA plan selection, 2 dental plan options offering orthodontia coverage and 3 cleanings per year, and 2 vision plan options.
- Company match 401(k) plan – 50% up to 6%!
- Support of your fitness wellness goals! We offer up to 75% off at over 11,000 gyms and fitness centers.
- Opportunity to prioritize your mental health with 24/7 access to licensed therapists.
- Pet benefits & discounts.
- Access to our Employee-led Resource Groups (ERGs) that lend a voice to the variety of demographics represented throughout our company.