Remote Medical Claims Examiner Jobs (NOW HIRING)

This is a remote position located in California.

Keenan is a leading insurance brokerage and consulting firm serving hospitals, public agencies, and California school districts. Specializing in employee benefits, workers' compensation, loss control, financial services, and property & liability. Keenan is committed to delivering innovative solutions that protect and empower the communities we serve.

As part of Gallagher, a global leader in insurance, risk management, and consulting, you’ll be joining a team that’s passionate about helping individuals and organizations thrive.

The Claims Examiner is responsible for liability claims and property damage claims to their conclusion in the most cost-effective way possible for the client. In addition, the Claims Examiner will be responsible for recognizing claims involving coverage issues and present them to the Claims and Coverage Committees for referral to counsel.

• Review assigned claims within the PLCA guidelines.
• Prepare appropriate response letter to Government Claims within the required timelines.
• Assignment of Investigations.
• Review investigative reports, evaluate damages and make recommendations to clients regarding assigned files.
• Direct attorneys on litigated files and control defense costs.
• Prepare timely Reports to Reinsurers.
• Prepare appropriate write ups for JPA’s/ Superpools on a quarterly basis.
• Monitor/adjust reserves when developments occur.
• Review files for Subrogation potential and actively pursue subrogation.
• Manage and respond to client inquiries.
• Maintain accurate statistical data in computer.
• Assist in client file reviews.
• Attend Court ordered Mediations/MSC’s or any meeting required to facilitate settlement
• Bill at minimum 80% of the work day.
• Other duties as assigned.

Required: 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.
Preferred: Bachelor's degree preferred.
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.

At Gallagher, we believe supporting our colleagues goes far beyond the role itself. For more information, visit our Benefits page.

• Competitive compensation
• Comprehensive benefits programs designed to support your well-being 
• Career development opportunities and ongoing learning 
• A collaborative, people-first culture with accessible leadership 
• The opportunity to do meaningful work with global reach and local impact 

At Gallagher, we are dedicated to building an inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to join our Talent Community to stay connected to additional career opportunities. At times, we will consider transferable skills from previous roles.

Gallagher is an affirmative action/equal opportunity employer (Minorities/Females/Veterans/Disabled)

Required: 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.
Preferred: Bachelor's degree preferred.
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.