Claim Examiner- WC job in Brea CA
TalentBurst, Brea, CA, United States
Job Title
Claim Examiner- WC
Location Brea, CA
Duration 3 Months
Job 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 to determine 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.
Establishes 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.
Makes settlement decisions promptly and equitably and issues company drafts in payments for claims within authority limits.
Develops subrogation and third‑party recovery potential and follows reclaim procedures.
Participates in claim reviews.
Abilities & Skills
Ability to work independently while assimilating various technical subjects.
Good verbal or written communication skills.
Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action.
Strong ability to identify, analyze and solve problems.
Effective interpersonal skills to be capable of dealing with external sources and all levels of employees.
Qualifications
Bachelor's degree or equivalent experience required.
Comprehensive claims investigations/settling experience (1‑3 years) in Claims or similar organization.
Why TalentBurst? At TalentBurst, we deliver more than talent, we deliver outcomes. We partner with you to move quickly and connect you to opportunities aligned with your skills and long‑term growth.
Backed by precision, transparency, and results, we connect top talent with leading organizations through trusted partnerships.
We offer competitive compensation and comprehensive benefits, including medical, dental, vision, and retirement options.
TalentBurst is an equal opportunity employer committed to an inclusive and diverse workforce.
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Location Brea, CA
Duration 3 Months
Job 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 to determine 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.
Establishes 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.
Makes settlement decisions promptly and equitably and issues company drafts in payments for claims within authority limits.
Develops subrogation and third‑party recovery potential and follows reclaim procedures.
Participates in claim reviews.
Abilities & Skills
Ability to work independently while assimilating various technical subjects.
Good verbal or written communication skills.
Demonstrated ability to gather and analyze information, determine a course of action and implement the selected course of action.
Strong ability to identify, analyze and solve problems.
Effective interpersonal skills to be capable of dealing with external sources and all levels of employees.
Qualifications
Bachelor's degree or equivalent experience required.
Comprehensive claims investigations/settling experience (1‑3 years) in Claims or similar organization.
Why TalentBurst? At TalentBurst, we deliver more than talent, we deliver outcomes. We partner with you to move quickly and connect you to opportunities aligned with your skills and long‑term growth.
Backed by precision, transparency, and results, we connect top talent with leading organizations through trusted partnerships.
We offer competitive compensation and comprehensive benefits, including medical, dental, vision, and retirement options.
TalentBurst is an equal opportunity employer committed to an inclusive and diverse workforce.
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