4 Sr. Claims Adjuster | Workers Compensation | Hybrid Jobs in Glendale, CA
SORT BY
S
Q
C
California Insurance Guarantee Association
Glendale, CA | Full Time
$73k-91k (estimate)
3 Months Ago
I
Sr. Claims Adjuster | Workers Compensation | Hybrid
$76k-95k (estimate)
Full Time
1 Week Ago
QuestPro is Hiring a Sr. Claims Adjuster | Workers Compensation | Hybrid Near Glendale, CA
Sr. Claims Adjuster | Workers Compensation | Hybrid
SummaryReports directly to the unit Claims Supervisor and may be called upon to provide technical backup in the absence of the Claims Supervisor. In accordance with applicable statutes and in keeping with company rules, regulations, and established performance objectives, is responsible for effectively managing to conclusion an assigned inventory of claim files that may include cases of extreme complexity or with unique or unusual issues.
Essential Duties And Responsibilities
CompetencyTo perform the job successfully, an individual should demonstrate the following competencies:
Education And/or ExperienceBachelor's degree (B. A.) from four-year college or university; at least seven years related experience and/or training; or equivalent combination of education and experience. Requires a high degree of claims handling expertise to include a minimum of at least five years experience managing indemnity cases, many with complex or high potential subrogation, rehabilitation, medical management, and/or legal issues & possess an SIP certificate.
SummaryReports directly to the unit Claims Supervisor and may be called upon to provide technical backup in the absence of the Claims Supervisor. In accordance with applicable statutes and in keeping with company rules, regulations, and established performance objectives, is responsible for effectively managing to conclusion an assigned inventory of claim files that may include cases of extreme complexity or with unique or unusual issues.
Essential Duties And Responsibilities
- Perform a three-point contact on all new losses within 24 hours of receipt of the claim to include the claimant, employer, and treating physician to document relevant facts surrounding the incident itself as well as disability and treatment status.
- Thoroughly and accurately document ongoing case facts and relevant information necessary for establishing compensability, the need for disability payments, the use of vendors, medical and expense payments, and what is being done to move the case toward closure.
- Assure that all assigned indemnity claims have an up to date plan of action outlining activities and actions anticipated for ultimately resolving the claim.
- Form a partnership with the medical case manager to maximize early return to work potential thereby reducing the need for extended disability payments, vocational rehabilitation, and other protracted claims costs.
- Initiate the referral to the SIU of cases with suspected fraud.
- Aggressively pursue subrogation from culpable third parties, contributions on multiple defendant cases, and apportionment when there is pre-existing disability.
- Assure that the claim file is handled totally in accordance with applicable statutes as well as in-force service contracts and company guidelines.
- Review and approve all vocational rehabilitation plans.
- Establish, monitor, and adjust monetary case reserves when warranted and in strict accordance with assigned authority levels.
- Review all medical bills for appropriateness prior to referral to InterMed for payment and posting to the claim file.
- Exhibit and maintain a courteous and helpful attitude and project a professional image on behalf of the company.
- Respond to telephone messages and inquiries within 24 hours of receipt and to written inquiries within one week of receipt.
- Requires a working knowledge of the Labor Code of the State of California as it pertains to workers compensation claims and the legal requirements for handling them.
- Litigation management - Direct, manage, and control the litigation process.
- Handles other duties and tasks as deemed appropriate by the Supervisor or Manager.
CompetencyTo perform the job successfully, an individual should demonstrate the following competencies:
- Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Uses reason even when dealing with emotional topics.
- Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Responds to requests for service and assistance; Meets commitments.
- Interpersonal - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
- Team Work - Supports everyone's efforts to succeed.
Education And/or ExperienceBachelor's degree (B. A.) from four-year college or university; at least seven years related experience and/or training; or equivalent combination of education and experience. Requires a high degree of claims handling expertise to include a minimum of at least five years experience managing indemnity cases, many with complex or high potential subrogation, rehabilitation, medical management, and/or legal issues & possess an SIP certificate.
Job Summary
JOB TYPE
Full Time
SALARY
$76k-95k (estimate)
POST DATE
09/02/2024
EXPIRATION DATE
09/28/2024
WEBSITE
questpro.com
HEADQUARTERS
Dallas, TX
SIZE
50 - 100
Related Companies
Show more
The job skills required for Sr. Claims Adjuster | Workers Compensation | Hybrid include Customer Service, Problem Solving, Claim Handling, Subrogation, Medical Management, etc. Having related job skills and expertise will give you an advantage when applying to be a Sr. Claims Adjuster | Workers Compensation | Hybrid. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Sr. Claims Adjuster | Workers Compensation | Hybrid. Select any job title you are interested in and start to search job requirements.
For the skill of Customer Service
Blackhawk Veterinary Hospital
Part Time
$43k-52k (estimate)
Just Posted
Show more
Similar Jobs
Popular Articles
Top 10 Things to Avoid Putting on a Job Application
Read Article
How to Describe Your Education in a Resume
Read Article
How to Write a Memorable Cover Letter in 5 Ways
Read Article
4 Personal Finance Tips to Make During Job Transition
Read Article
4 Best Camera Setups for Interview
Read Article
Keeping a Job Search Journal: 9 Types of Journaling You Can Do
Read Article
