Sr Claim Examiner- WC

Responsibilities

• Interprets and makes decisions using independent judgment on more complex and unusual policy coverages and determines if coverages apply to claims submitted.
• Manages all aspects of investigative activity on complex claims and directs discovery and litigation strategy with legal counsel.
• Analyzes claims activity and prepares reports for clients, carriers and management.
• Establishes reserves, using independent judgement and expertise, and authorises payments within scope of authority, settling claims in the most cost effective manner and ensuring timely issuance of disbursements.
• Settles claims promptly and equitably and issues company drafts of payments for claims within authority limits.
• Develops subrogation and third‑party recovery potential and follows reclaim procedures.
• Participates in claim reviews.

• Ability to work independently while assimilating various technical subjects.
• Strong written and oral communication, negotiation and presentation skills.
• Advanced analytical and problem‑solving skills, with the ability to manage and prioritise multiple projects.