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Claims Examiner- Liability

  • Location: California
  • Job Type:Contract

Posted 20 days ago

  • Expiry Date: 06 February 2022

​​​​​​Job Description:

  • To analyze complex or technically difficult general liability claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.  

Responsibilities:

  • Analyzes and processes complex or technically difficult general liability claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. 

  • Assesses liability and resolves claims within evaluation. 

  • Negotiates settlement of claims within designated authority. Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. 

  • Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. 

  • Prepares necessary state fillings within statutory limits. Manages the litigation process; ensures timely and cost effective claims resolution. 

  • Coordinates vendor referrals for additional investigation and/or litigation management. 

  • Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. 

  • Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. 

  • Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner. 

  • Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. 

  • Ensures claim files are properly documented and claims coding is correct. 

  • Refers cases as appropriate to supervisor and management. 

Additional:

  • Performs other duties as assigned. Supports the organization's quality program(s). 

  • Travels as required. 

Qualification:

  • Education & LicensingBachelor's degree from an accredited college or university preferred. 

  • Professional certification as applicable to line of business preferred. 

  • ExperienceFive (5) years of claims management experience or equivalent combination of education and experience required. 

Skills & Knowledge:

  • Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.  

About ASK:ASK Consulting is an award-winning technology and professional services recruiting firm servicing Fortune 500 organizations nationally. With 5 nationwide offices, two global delivery centers, and employees in 42 states-ASK Consulting connects people with amazing opportunities

ASK Consulting is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all associates.