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Claim Examiner- WC

Company

Paladin Consulting, Inc.

Location

Brea, California, United States

Type

Full-time

Description:

  • Receives claim assignment, confirms policy coverages and directs acknowledgement of claims.

  • Interprets and makes decisions using independent judgment on moderate difficulty claims and policy coverages and determines if coverages apply to claims submitted.

  • Investigates, evaluates, negotiates and adjudicates first and third party claims to determine validity and verify extent of damage by telephone contact with clients, claimants, witnesses or other parties as required.

  • Analyzes claims activity and prepares reports for clients/carriers and management.

  • Establish reserves, using independent judgment and expertise and authorizes payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements.

  • Make settlement decisions promptly and equitably and issues company drafts in payments for claims within authority limits.

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