Sr. Claims Examiner
The Claims Adjuster is responsible for the prompt and efficient examination, investigation, settlement or declination of worker's compensation insurance claims through effective research, negotiation, and interaction with insurers, and claimants ensuring that company resources are utilized in a cost-effective manner in the process. The adjuster reports to a WC Supervisor.
• Review, process and conclude high exposure liability claims or those limited in exposure but occasionally complex in nature
• Oversee and direct a majority of litigated or potentially litigated claims, directing and controlling the work and expenses of investigative services or attorneys
• Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud and resolution potential
• Conduct a thorough analysis of liability and damages; continually assess exposure and evaluate for accurate reserves
• Complete quality investigations by gathering all pertinent information (recorded statements, review of police and medical reports, photographs and appraisals/estimates of damages, etc.)
• Determines if subrogation exists and takes steps necessary to initiate recovery efforts
• Maintains appropriate financial accountabilities (reserving) and controls loss adjustment expenses
• Fulfill state licensing agreements/requirements (if applicable) and apply knowledge of state laws and regulations pertaining to the insurance industry Qualifications
• Bachelor's degree preferred
• 5 to 6 years' experience in handling workers comp claims to Maintain valid adjusters' license(s) in states assigned or an ability to obtain same
• 2 years' experience in job-related functions or equivalent
• Insurance coursework (e.g. IIA, CPCU, SCLA, and AEI) is beneficial
• Good knowledge of insurance theory and practices; insurance contracts and their application
Canon Recruiting Group, LLC. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Canon Recruiting Group, LLC. complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.