Catastrophic Claims Examiner
- Employer
- Preferred Employers Insurance
- Location
- San Diego, CA
- Salary
- DOE
- Posted
- Aug 11, 2016
- Closes
- Sep 14, 2016
- Category
- Claims, Workers' Compensation
- Job Type
- Full Time
- Career Level
- Experienced (Non-Manager)
The Major Case Claims Examiner is responsible for the analysis and management of Catastrophic and/or complex workers’ compensation claims. The Major Case Claims Examiner will have 12 or more years in Worker’s Compensation claims progressing through the technical ranks.
This position will analyze, investigate, and make recommendations regarding coverage, compensability, and appropriateness of claims. In addition, the Major Case Claims Examiner will work closely with the medical unit and medical vendors to mange the medical care in catastrophic cases.
The role of the Major Case Claims Examiner is one of technical expertise and leadership. The position carries with it the responsibility to demonstrate and advance corporate values along with the required technical expertise. The Major Case Claims Examiner position represents advancement from the Senior Claims Examiner position while developing the technical and leadership skills required to be a Chief Claims Examiner.
This position will process and document claims to ensure compliance with company standards, industry best practices, and legislative provisions. The Major Case Claims Examiner acts in a fiduciary role on behalf of policyholders, negotiates claim settlements and manages subrogation. Major Case 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.