Gallagher
Senior Claims Examiner, Workers' Compensation
Gallagher, Sacramento, California, United States, 95828
Introduction
Join a global brokerage team that embraces diverse talents to protect businesses and empower ambitions.
Base pay range $60,000.00/yr - $117,000.00/yr
Overview Keankan, a leading insurance brokerage, serves hospitals, public agencies, and California school districts. Gallagher, a global leader in risk management, invites a Senior Claims Examiner to administer indemnity claims and resolve complex claim issues in a remote California location.
How You'll Make An Impact
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.
About You Required: High school diploma and 5 years related claims experience. Appropriately licensed and/or certified in all states in which claims are being handled or able to obtain the licenses/certification per local requirements. Extensive knowledge of accepted industry standards and practices. Computer experience with related claims and business software.
Preferred: Bachelor's degree.
Behaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Analytical skill necessary to make decisions and resolve complex issues inherent in handling losses. Ability to successfully negotiate the settlement and disposition of serious claims including the ability to interpret related documentation.
Compensation And Benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. On top of a competitive salary, we also offer a wide range of benefits.
Medical/dental/vision plans, which start from day one!
Life and accident insurance.
401(k) and Roth options.
Tax‑advantaged accounts (HSA, FSA).
Educational expense reimbursement.
Paid parental leave.
Other benefits include
Digital mental health services (Talkspace).
Flexible work hours (availability varies by office and job function).
Training programs.
Gallagher Thrive program – elevating your health through workshops and digital fitness programs for your overall wellbeing.
Charitable matching gift program.
And more…
The benefits summary above applies to full‑time positions. If you are not applying for a full‑time position, details about benefits will be provided during the selection process.
We value inclusion and diversity Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non‑conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected by applicable federal, state, or local laws.
Equal employment opportunity will be extended in all aspects of the employer‑employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.
Seniority level Not Applicable
Employment type Full-time
Job function Finance and Sales
Industries Insurance
Location Remote, California
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Base pay range $60,000.00/yr - $117,000.00/yr
Overview Keankan, a leading insurance brokerage, serves hospitals, public agencies, and California school districts. Gallagher, a global leader in risk management, invites a Senior Claims Examiner to administer indemnity claims and resolve complex claim issues in a remote California location.
How You'll Make An Impact
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.
About You Required: High school diploma and 5 years related claims experience. Appropriately licensed and/or certified in all states in which claims are being handled or able to obtain the licenses/certification per local requirements. Extensive knowledge of accepted industry standards and practices. Computer experience with related claims and business software.
Preferred: Bachelor's degree.
Behaviors: Ability to think critically, solve problems, plan and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges. Analytical skill necessary to make decisions and resolve complex issues inherent in handling losses. Ability to successfully negotiate the settlement and disposition of serious claims including the ability to interpret related documentation.
Compensation And Benefits We offer a competitive and comprehensive compensation package. The base salary range represents the anticipated low end and high end of the range for this position. On top of a competitive salary, we also offer a wide range of benefits.
Medical/dental/vision plans, which start from day one!
Life and accident insurance.
401(k) and Roth options.
Tax‑advantaged accounts (HSA, FSA).
Educational expense reimbursement.
Paid parental leave.
Other benefits include
Digital mental health services (Talkspace).
Flexible work hours (availability varies by office and job function).
Training programs.
Gallagher Thrive program – elevating your health through workshops and digital fitness programs for your overall wellbeing.
Charitable matching gift program.
And more…
The benefits summary above applies to full‑time positions. If you are not applying for a full‑time position, details about benefits will be provided during the selection process.
We value inclusion and diversity Gallagher believes that all persons are entitled to equal employment opportunity and prohibits any form of discrimination by its managers, employees, vendors or customers based on race, color, religion, creed, gender (including pregnancy status), sexual orientation, gender identity (which includes transgender and other gender non‑conforming individuals), gender expression, hair expression, marital status, parental status, age, national origin, ancestry, disability, medical condition, genetic information, veteran or military status, citizenship status, or any other characteristic protected by applicable federal, state, or local laws.
Equal employment opportunity will be extended in all aspects of the employer‑employee relationship, including, but not limited to, recruitment, hiring, training, promotion, transfer, demotion, compensation, benefits, layoff, and termination. In addition, Gallagher will make reasonable accommodations to known physical or mental limitations of an otherwise qualified person with a disability, unless the accommodation would impose an undue hardship on the operation of our business.
Seniority level Not Applicable
Employment type Full-time
Job function Finance and Sales
Industries Insurance
Location Remote, California
#J-18808-Ljbffr