Senior Workers' Comp Claims Specialist - CA Claims

Responsibilities

• Investigate, analyze, and determine the extent of company's liability concerning Claims and attempt to effect settlement with claimants.
• Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information.
• Calculate benefit payments and approve payment of Claims within a certain monetary limit.
• Follows appropriate procedures for system documentation to preserve data integrity.
• Maintains regular contact with injured workers, employers and agents to develop positive relationships and establish credibility.
• Create and execute action plans needed to bring case to closure.
• Completes detailed settlement evaluations and recommends appropriate settlement value, within authority; negotiates claim settlements with injured workers and/or injured workers’ attorneys.
• Maintains accuracy of reserves over the life of the claim; when new information is received re-evaluates and recommends reserves according to Zenith’s standards.

Qualifications

• California Workers' Compensation Claims Adjuster Certification/ designation.
• High School Diploma Or equivalent required.
• Bachelor’s Degree or equivalent required.
• 5+ years Workers’ Compensation Claims handling experience required.
• CA workers Comp claims experience is a must.

Knowledge, Skills, And Abilities

• Advanced technical workers’ compensation claims knowledge.
• Strong verbal and written communication skills with emphasis on telephone communication required.
• Strong math and reading skills required.
• Mets all state regulatory standards regarding licensing, continuing education, and other requirements.