• Verify coverage, investigate liability, and determine the scope of damages for assigned bodily injury claims. • Conduct thorough, detailed, and accurate investigations to evaluate claim facts and determine appropriate resolutions. • Evaluate accident facts, injuries, medical records, and medical bills to determine causation, liability, and claim value. • Analyze claim information and move claims toward timely and appropriate resolution. • Negotiate settlements in accordance with company best claim practices and applicable state regulations. • Manage an assigned inventory of bodily injury claims while working independently and making sound claims decisions. • Maintain ownership of the claim throughout the claim lifecycle while providing a seamless customer experience. • Provide proactive, transparent, and timely communication to customers, claimants, attorneys, and other involved parties. • Deliver an extraordinary customer experience through professionalism, empathy, and responsive service. • Collaborate with internal departments and external vendors to ensure efficient claim resolution. • Continue building technical knowledge of bodily injury claims, litigation, and regulatory requirements.

• Investigate and manage complex bodily injury claims, including litigation, uninsured/underinsured motorist claims, and other high-exposure losses. • Verify coverage, determine liability, evaluate damages, and conduct thorough investigations to support claim decisions. • Analyze medical documentation, applicable laws, and case precedent to complete comprehensive bodily injury evaluations. • Demonstrate sound judgment in evaluating liability, damages, and settlement opportunities. • Manage injury litigation from assignment through resolution. • Prepare mediation and arbitration submissions and represent the company through the dispute resolution process. • Partner with defense counsel and other legal professionals to develop claim strategies and achieve appropriate outcomes. • Negotiate settlements while adhering to company best claim practices and regulatory requirements. • Deliver an exceptional customer experience by maintaining proactive, transparent communication throughout the life of the claim. • Keep insureds, claimants, attorneys, and other involved parties informed regarding claim status and resolution. • Handle sensitive and high-stress customer interactions with professionalism and empathy. • Serve as a technical resource and subject matter expert for complex bodily injury claims. • Mentor and provide guidance to less experienced claim professionals. • Share knowledge and best practices to support team development and continuous improvement. • Maintain compliance with all state regulations, company policies, and claims handling standards. • Obtain and maintain all required state adjuster licenses. • Effectively utilize claims management systems and other technology tools to manage assigned inventory. • Maintain ownership of assigned claims while meeting quality, productivity, and service expectations.

Role Description This is a remote position based in California, and candidates must reside within the state. As a Senior Claims Examiner, you’ll play a vital role in helping businesses and individuals navigate complex Workers' Compensation claims. This is your opportunity to make a meaningful impact by resolving claims efficiently, mitigating risks, and delivering exceptional service. In this role, you’ll manage Workers' Compensation indemnity claims, ensuring they’re handled with care and precision. You’ll oversee complex claim issues, leveraging your expertise in litigation management and lien resolution to achieve fair outcomes. Your day-to-day will involve: - Maintaining accurate claim diaries - Updating reserves - Ensuring timely reporting to key stakeholders - Collaborating with legal teams - Identifying opportunities for subrogation - Working closely with clients to maintain satisfaction Additionally, you’ll: - Prepare and attend file reviews to ensure claims are progressing effectively - Negotiate settlements and resolve outstanding liens - Monitor and guide defense attorneys to achieve optimal outcomes - Ensure compliance with all regulatory requirements and deadlines Qualifications - High school diploma and 5 years related claims experience required - 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 - Bachelor's degree preferred Requirements - Ability to think critically and solve problems - Plan and organize activities - Serve clients and negotiate - Effectively communicate verbally and in writing - 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 - Ability to interpret related documentation

Role Description Bring your claims expertise to a remote team committed to service excellence and operational success. - Work Style: Remote - Location Requirement: Gainesville, FL - FTE: Full-Time (1.0 FTE) This position is responsible for coordinating incoming and outgoing payer correspondence, reviewing claim documentation, supporting Epic account updates, and ensuring accurate claim processing and routing. Ideal candidates are detail-oriented, analytical, and thrive in a fast-paced environment while helping drive efficiency and accuracy across the revenue cycle team. Qualifications - High School Diploma/Equivalent Requirements - 2+ years of experience in insurance claims processing and support. - Working knowledge of insurance policies, coverage, and claims adjudication processes. - Experience investigating, analyzing, and resolving claim-related issues. - Strong communication and customer service skills with the ability to interact effectively with claimants and stakeholders. - Demonstrated ability to maintain accurate records and ensure compliance with regulatory and audit requirements.