Workers' Comp CA Licensed Claims Adjuster- Remote - Contract - CA
Job Description
Job Description... Workers' Compensation CA Licensed Claims Adjuster, Senior Remote Contract - California Fairbanks Claims Administration $50/hour contract to permanent
Overview
Fairbanks Claims Administration is a high-deductible and self-insured workers compensation TPA building a team of excellent adjusters. Workers' Compensation Claims Adjuster, Senior As a Workers' Compensation Claims Adjuster, Senior, you will be responsible for the investigation and adjustment of assigned claims. Key Details Location: Remote Schedule: Monday to Friday, Contract to Permanent Types of Accounts: Light Industrial, other Miscellaneous Jurisdictions: California License Required: California Adjuster's License, do not apply if you do not have a license Preferred Certifications: SIP/WCCA/WCCP/AIC Computer Skills Required: Proficient in reputed company Office Computer Skills Preferred: Proficient in ClaimPilot Responsibilities Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws. Establish reserves and/or provide reserve recommendations reputed company established reserve authority levels. Review, approve or provide reputed company of medical and legal estimates and miscellaneous invoices to determine if reasonable and reputed company to designated claims. Negotiate any disputed bills or invoices for resolution. Authorize and reputed company payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and reputed company established payment authority. Negotiate settlements in accordance with best practices, client specific handling instructions and state laws, reputed company appropriate. Assist in the selection, referral and supervision of designated claim files sent to reputed company vendors. (i.e. legal, surveillance, case management, etc.) Review and maintain personal diary on claim system. Assess and monitor subrogation claims for resolution. Prepare reports detailing claim status, payments and reserves, as requested. Provide notices of qualifying claims to excess/reinsurance carriers. Conduct claim reviews and/or training sessions for clients, as requested. Attend and participate at hearings, mediations, and informal legal conferences, as appropriate. Administer benefits on claims. Ensure timely utilization review (UR) processing. Process bills promptly. Communicate effectively with injured workers, clients, and attorneys. Maintain proper documentation of the claim file in a timely manner. Provide summary updates every 30, 60, or 90 days. Drive claims to resolution. Performs other duties as assigned. Qualifications Excellent oral and written communication skills. Initiative to set and reputed company performance goals. Good analytic and negotiation skills. Ability to cope with job pressures in a constantly changing environment. Knowledge of reputed company reputed company level claim position responsibilities. Must be detail-oriented and a self-starter with strong organizational abilities. Ability to coordinate and prioritize required. Flexibility, accuracy, initiative and the ability to work with minimum supervision. Discretion and confidentiality required. Reliable, predictable attendance reputed company client service hours for the performance of this position. reputed company to internal and external client needs. Ability to clearly communicate verbally and/or in writing, both internally and externally. Performance Timely payment of benefits with no self-imposed penalties. Keeping diaries and mail up to date. Appropriately reserving files for the most probable outcome. Education And/or Experience 5+ years of experience as a claims examiner handling semi-reputed company to reputed company-level claims. Strong analytical and problem-solving skills. Excellent communication and negotiation abilities. Ability to work independently and manage multiple priorities Apply Job!