What are the responsibilities and job description for the Claims Examiner - Workers Compensation - REMOTE (CA) position at BCForward?
Job Description
Job Description
BCforward is currently seeking a highly motivated Claims Examiner - Workers Compensation for an opportunity in San Diego, CA 92123.
Job Details :
Job Title : Claims Examiner - Workers Compensation
Location : Remote (CA)
Duration : 3 months of contract
Pay Rate : $45.00 / hr. on W2
Anticipated Start : ASAP
Remote in CA however, if candidate is near San Diego or Roseville office, client would like to have a hybrid role but not a deal breaker.
Min 3 years of experience with CA claims mandatory
Job Description :
To analyze complex or technically difficult workers' compensation claims, determining benefits due while managing high-exposure claims involving litigation and rehabilitation. Ensure ongoing adjudication of claims aligns with service expectations, industry best practices, and specific client requirements. Identify subrogation opportunities and negotiate settlements.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES :
- Analyze and manage complex or technically challenging workers' compensation claims, developing actionable plans for timely resolution.
- Negotiate claim settlements within designated authority.
- Calculate and assign reserves promptly, ensuring reserve adequacy throughout the claim lifecycle.
- Process and approve timely claim payments and adjustments within authority limits.
- Prepare and submit state filings within statutory guidelines.
- Oversee litigation processes to ensure timely and cost-effective claim resolution.
- Coordinate vendor referrals for further investigation or litigation management as needed.
- Employ cost containment strategies, including strategic vendor partnerships, to minimize overall claim costs.
- Manage recoveries such as subrogation, Second Injury Fund excess recoveries, and Social Security / Medicare offsets.
- Communicate effectively with claimants and clients, maintaining professional relationships.
- Ensure accurate documentation and coding of claim files.
- Refer complex cases to supervisors or management as appropriate.
Qualifications :
Education & Licensing :
Experience :
Skills & Knowledge :
WORK ENVIRONMENT : Mental :
Physical :
Auditory / Visual :
ADDITIONAL REQUIREMENTS :
Company Description
About BCforward :
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class places to work.
BCforward is an equal opportunity employer.
Company Description
About BCforward : Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally. BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class places to work. BCforward is an equal opportunity employer.
Salary : $45
