Claims Jobs in Simi Valley, CA

Summary :

This position involves handling property and casualty as well as workers' compensation claim-related issues.

The following details a general list of duties, qualifications, and abilities for this position. Training, resources and continuing education will also be provided by the company to ensure that the new team member is able to accomplish the requirements of the role.

Duties :

• Work with clients, Account Executives / Managers, and Risk Control Team to create schedules of services for risk management accounts based on company size, scope of work, and loss history.
• Report client Property & Casualty claims and as directed by the Claims Risk Advisor.
• Conduct non-urgent claim follow-ups and status requests.
• Manage all claims-related activities assigned. Activities range from LOSS per each claim to quarterly open claim updates (LCXC).
• Strategize with clients to develop mutually agreed upon Property & Casualty claims management techniques including utilization of the Medical Provider Network, formal first aid programs, and early return to work.
• Strategize with clients to develop mutually agreed upon Property & Casualty claims prevention and management techniques including accident investigation and sub-contractor pre-qualification practices.
• Act as an advocate for our clients with our insurance company partners to ensure proactive claims handling, appropriate reserving, compliance by all parties within insurance regulations, and aggressive legal defense.
• Claim Review Assistance Gathering Loss Runs for all Risk Control claims functions.
• Attend in-person or virtual quarterly claim reviews with the Claims Risk Advisor, clients, and insurance carriers. Manage the schedule of reviews to ensure timely delivery and participation by appropriate parties.
• Documentation Preparation formatting, proof-reading, branding, printing, binding of all documents for claim reviews, such as Loss Runs and Claim Status Reports, as needed. Bring together all materials for claim reviews.

Qualifications

Abilities