Claims Examiner-Senior - (R6384)

Cambridge Integrated Services Group, Inc., a Scandent Group company, is one of the largest business process outsourcing networks in the United States, Australia, India and the United Kingdom, and the largest independently owned property and casualty claims and loss cost management service provider in the U.S

Currently, we have an excellent opportunity available for a Senior Claims Examiner-Field Claim Services to join our rapidly growing company. This position is located in our Pasadena, CA office and the job code is R6384.

Primary responsibilities for this position include:
* Manage and direct indemnity claims from inception to conclusion
* Implements the appropriate procedures to minimize client's exposure
* Reserve files accurately in accordance with injury type and other applicable factors identifying potential costs of medical care, investigation and indemnity benefits
* Negotiates and prepares claims for settlement
* Ensures timely payment of all indemnity benefits, bills and appropriate benefit notices and forms per statutory requirements
* Represents company and client's interest at all times
* Monitors claim to identify pre-established criteria for case management and vocational rehabilitation for timely referrals in accordance with state laws
* Directs closure of claim to maintain the appropriate caseload and established performance goals/standards
* Provides direction to clients, legal counsel, and injured workers
* Monitors claims for fraud potential and subrogation possibilities
* Interact with client

Qualified Candidates Will Have:
* High School Diploma, some college
* IEA Certification
* Self Insured Certification
* Minimum 5 years W/C Adjusting Experience
* Experience in self insured or carrier setting
* Keen understanding of the CA Work Comp Rules and Regulations
* Ability to investigate and process WC benefits
* Familiarity with rating permanent disability
* Solid communication and time management skills
* Ability to recognize issues and move files to resolution
* This position is being requested to assist in the review of caseloads in order to determine files that are ready for closure as well to review ongoing litigated matters needing resolution

Cambridge offers:
* Competitive Compensation
* Exceptional Benefits
* Continuing Education & Training
* Internal Advancement Opportunities
* Tremendous Potential With A Growing Worldwide Organization

Salary history must be included for resume consideration
(No phone calls or walk-ins accepted)

Cambridge Integrated Services Group, Inc. is an Equal Opportunity Employer. M/F/D/V

Apply now via the posting option provided


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