Senior and Mid Level Workers Compensation Claims Examiners

Orange, California
Not Specified
Dec 11, 2018
Feb 08, 2019
Job Type
Not Specified
Career Level
Not Specified

At York, we believe that an experience marked by expertise, consistency and compassion sets us apart. And we celebrate the diverse backgrounds and unique perspectives that allow us to stand apart from our competitors. Thats why we are committed to recruiting, developing and retaining people who represent our values and who believe in our mission.

Job Description

Senior Workers Compensation Claims Examiner

A Senior Workers Compensation Claims Examiner is an experienced claims examiner who works under only general supervision and utilizes his or her training to review, examine, investigate, analyze and resolve workers compensation claims. As set forth in greater detail below, the examiners primary duties are interviewing witnesses and assessing credibility; reviewing factual information to prepare reserves and damage estimates; evaluating and making recommendations regarding coverage of claims; determining liability and total value of a claim; negotiating settlements; and making recommendations regarding litigation and assisting managers with management and mentoring functions.

This position functions with a high level of claim-management and financial autonomy and performs a variety of complex technical duties within the general limitations of State Workers Compensation laws, Yorks best practices, and client service instructions.

A Senior Workers Compensation Claims Examiner also assists the Unit Manager with mentoring, onboarding new hires and functions as a back up to the Unit Manager as needed.

Mid Level Workers Compensation Claims Examiner

Investigates claims to determine an injured workers entitlement to Workers Compensation benefits; Administers indemnity and medical benefits for valid Workers Compensation claims; manages a caseload of claims from inception to closing or settlement.

  • Completes 3-point contact on new claims within 24 hours in order to obtain information necessary to make a compensability decision on the claim
  • Establishes appropriate reserve levels based on financial exposure and updates reserves upon receipt of new information
  • Directs assistant to properly pay indemnity benefits and Awards. Issue state-mandated benefit notices within the required timeframes
  • Annotates, categorizes and addresses incoming mail on a daily basis
  • Responds to questions and requests from the client
  • Strong proficiency in keyboarding and data entry skills; most time spent in front of a computer entering text with applications.
  • Must be able to type accurately, enter information into a computerized system

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