What are the responsibilities and job description for the Workers Compensation Claims Examiner position at Adecco US, Inc.?
Adecco is currently assisting one of its clients in their search for a Workers Compensation Claims Examiner in Roseville, CA or Long Beach, CA!
Pay rate : $48.08 / hr onsite
Shift availability : Mon – Fri, 8a-5p
For instant consideration for this role, click on Apply Now and upload your resume.
PRIMARY PURPOSE : To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.
Our ideal candidate must have / must be able to :
Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution
Negotiates settlement of claims within designated authority
Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim
Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level
Prepares necessary state fillings within statutory limits
Manages the litigation process; ensures timely and cost-effective claims resolution
Coordinates vendor referrals for additional investigation and / or litigation management
Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients
Manages claim recoveries, including but not limited to : subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets
Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner
Communicates claim activity and processing with the claimant and the client; maintains professional client relationships
Ensures claim files are properly documented and claims coding is correct
Other duties as assigned
Education / Certification Requirements :
High School Diploma or equivalent
Bachelors preferred
Experience requirements :
10 years of CA Workers Compensation experience
Indemnity and litigation experience a must
SIP preferred
Excellent communication skills
Strong negotiation skills
As a reminder, this role is being recruited for by one of our National Recruitment Teams and not your local Branch. In order to be considered, please follow the steps included upon your application. If you are interested in a WC Claims Examiner position in Roseville, CA or Long Beach, CA APPLY NOW for instant consideration!
Pay Details : $48.08 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer / Veterans / Disabled
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The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and / or security clearance requirements, including, as applicable :
The California Fair Chance Act
Los Angeles City Fair Chance Ordinance
Los Angeles County Fair Chance Ordinance for Employers
San Francisco Fair Chance Ordinance
Salary : $48
