RiversideRecruiter Since 2001
the smart solution for Riverside jobs

Senior Claims Examiner

Company: Keenan & Associates
Location: Riverside
Posted on: December 5, 2019

Job Description:

OverviewAdminister indemnity claims and handle complex claim issues. Use strong litigation management experience, lien resolution abilities, and customer service skills to resolve routine claims without legal representation. ResponsibilitiesAdminister indemnity claims and handle complex claim issues. Use strong litigation management experience, lien resolution abilities, and customer service skills to resolve routine claims without legal representation. ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: - Maintain current diary. - Identify, prevent and mitigate potential penalties. - Update claim notes in computer. - Provide timely reporting of excess files to the Reinsurance Manager. - Report SIU/Fraud. - Identify and pursue subrogation. - Complete Rehab forms/benefit notices/SJDB/RTW form. - Refer all PRIME deletions only to office designee. - Update reserves no later than 30 days of receipt of information modifying the financial exposure of a claim. - Prepare for and attend file reviews. - Accept or deny delayed claims within 90 days. - Request settlement authorization/notification within 30 days of a final P&S report and prior to the MSC date. - Complete Stipulation and/or Compromise and Release paperwork. - Maintain 100% closing ratio on active accounts and reduce run off accounts by 25% annually. - Prepare legal referrals, provide direction to and monitor defense attorney. - Return all phone calls within 24 hours. - Complete instruction sheets for Assistant/Technician/Claims entry clerk. - Review mail daily. - Correct error report daily. - Maintain client/claimant satisfaction. - Update Unit Stat forms. - Oversee new set-ups, reserves and instruction sheets. - Prepare cover letters to AME/defense QME, AOE/COE evaluations. - Negotiate outstanding liens. - Make 3-point contact. - File Answer/Application. - Interaction with nurse on case management. - Other duties assigned. MINIMUM SUGGESTED QUALIFICATIONS: - Minimum of five (5) years of California Claims Examiner experience and a Self-Insurance Certificate, or the ability to pass Self-Insurance Test within one (1) year of hire. WCCP preferred. - Two (2) years of experience in handling school district claims is preferred. - Effective in verbal and written communication. SOFTWARE: Proficient in Microsoft Outlook, Excel, PowerPoint and Word. Adept at accessing business data from the Internet when required. PHYSICAL DEMANDS: While performing the duties of this job, the employee is regularly required to use manual dexterity, handle, or feel objects, tools, or controls; reach with hands and arms; and speak or hear. The employee frequently is required to walk, stand and sit. Position requires employee to frequently exert up to 10 pounds of force to move objects and occasionally exert up to 20 pounds of force to move objects. REASONING ABILITY: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, verbal, diagram, or schedule form. WORK ENVIRONMENT: Normally not exposed to conditions that are discomforting or disagreeable.PandoLogic. Keywords: Insurance Examiner, Location: Riverside, CA - 92522

Keywords: Keenan & Associates, Riverside , Senior Claims Examiner, Other , Riverside, California

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


Uber Eats Part-Time Delivery
Description: Deliver with Uber. Earn on your schedule. br Work on your schedule. Deliver for a few hours in the mornings, every night, or just on weekends-it's up to you. br Earn Good Money. You'll earn by bringing (more...)
Company: Uber Eats
Location: Placentia
Posted on: 12/9/2019

Now Hiring: Walmart
Description: Easy Application
Company: walmart.com
Location: Cathedral City
Posted on: 12/9/2019

Med/Surg Telemetry Registered Nurse - Travel RN
Description: InSync Consulting is urgently seeking several MS/Tele Registered Nurses RN for Day and Night shifts for a fantastic hospital in the Northern CA area. Interviews are happening very
Company: InSync Consulting Services
Location: Placentia
Posted on: 12/9/2019


Med/Surg Telemetry Registered Nurse - Travel RN
Description: InSync Consulting is urgently seeking several MS/Tele Registered Nurses RN for Day and Night shifts for a fantastic hospital in the Northern CA area. Interviews are happening very
Company: InSync Consulting Services
Location: Yucaipa
Posted on: 12/9/2019

Outside Sales - Route Sales - Established Route + Training
Description: Build a Great Career and a Quality Life with Mac Tools. Sales job title: Outside Sales - Route Sales - Established Route Training Feel the freedom and independence of working on your own, in a stress (more...)
Company: Mac Tools
Location: Palm Desert
Posted on: 12/9/2019

Drivers Wanted
Description: At Veyo, we help people get to and from their healthcare appointments. We're looking for drivers to partner with us in your area. When you sign up to drive with Veyo, you can drive your own vehicle and (more...)
Company: Veyo
Location: Placentia
Posted on: 12/9/2019

Now Hiring: Amazon
Description: Easy Application
Company: Amazon.com
Location: La Quinta
Posted on: 12/9/2019

Merrill Edge Financial Solutions Advisor - Altadena Financial Center - Altadena, CA
Description: Job Description:At Bank of America, we re creating real, meaningful relationships with individuals and businesses across the country. Each day, we connect with 67 million clients through a growing specialist (more...)
Company: Bank of America
Location: Altadena
Posted on: 12/9/2019

Now Hiring: Amazon
Description: Easy Application
Company: Amazon.com
Location: Altadena
Posted on: 12/9/2019

Med/Surg Telemetry Registered Nurse - Travel RN
Description: InSync Consulting is urgently seeking several MS/Tele Registered Nurses RN for Day and Night shifts for a fantastic hospital in the Northern CA area. Interviews are happening very
Company: InSync Consulting Services
Location: Colton
Posted on: 12/9/2019

Log In or Create An Account

Get the latest California jobs by following @recnetCA on Twitter!

Riverside RSS job feeds