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Reviews and analyzes Revenue Agent (Examiner), Appeals Officer, and Counsel Attorney instructions, reports, case files, and support statements and interprets tax law court decisions and legal opinions to determine and prepare accurate computations for the most demanding and complex Appeals cases.
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PRIMARY PURPOSE : To analyze complex or technically difficult workers' compensation 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.
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To analyze complex or technically difficult workers' compensation 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.
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Apply your examiner knowledge and experience to adjudicate complex customer claims in the context of an energetic culture. Workers Compensation Claims Adjuster | Orange, CA. To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
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Job Description: Pay Range $42hr - $47hr Responsibilities: Analyzes and processes complex or technically difficult workers' compensation 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.
$42 - $47 an hourRemoteExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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ESSENTIAL FUNCTIONS and RESPONSIBILITIES Analyzes and processes complex or technically difficult workers' compensation 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.
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California WC claims knowledge. Min. 3 Years of experience. OSIP certificate - Preferred.
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Conducts independent examinations, reviews, and related financial investigations of complex cases encompassing all types of financial institutions (FIs) and non-financial trades or businesses (NFTBs) to assure their compliance with statutory and regulatory requirements of Title 31 (Bank Secrecy Act), and Form 8300 filing.
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Overview To analyze complex or technically difficult workers' compensation 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.
$40 - $47.86 an hourFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Sub-trade certifications from the International Code Council for Plumbing, Mechanical, and/or Electrical Plans Examiner is highly desirable. Certification as a Building Plans Examiner from the International Conference of Building Officials or the International Code Council.
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Certified Anti-Money Laundering Specialist (CAMS), Certified Fraud Examiner (CFE) certification, Certified Financial Crime Specialist (CFCS), or other applicable industry designation preferred.
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Five or more years of progressive experience as a Claim Examiner, or the equivalent, demonstrating the technical expertise to handle the most complex cases with a high degree of judgment and discretion.
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Reviews, analyzes, and assigns losses to the appropriate claim examiner with directives. Industry designations preferred but not required (IIA, AIC, AEI and/or CPCU) Under general direction, supervises the investigation, management, and timely disposition of Workers Compensation claims within account, carrier and/or company guidelines, and assists the VP and/or Assistant VP of Claims in managing the Service Center.
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To supervise the operation of multiple teams of examiners and technical staff for workers compensation for clients; to monitor colleagues' workloads, provide training, and monitor individual claim activities; to provide technical/jurisdictional direction to examiner reports on claims adjudication; and to maintain a diary on claims in the teams including frequent diaries on complex or high exposure claims.
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CGS is seeking a Senior Auditor who will assist the district legal staff by conducting medical claims data analysis, forensic investigations, financial damages, statistical sampling, and ability-to-pay analyses, which serve a significant role in determinations regarding investigations, prosecutions, settlements, and recovery in these matters, which can be voluminous and complex.
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examiner complex jobs in Orange, CA
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