Claims Adjuster - Workers Compensation

El Dorado Hills, CA, US • Posted 1 day ago • Updated 1 day ago
Contract W2
3 Months
No Travel Required
On-site
$37 - $40/hr
Fitment

Dice Job Match Score™

🔢 Crunching numbers...

Job Details

Skills

  • Workers Compensation
  • Claims Management
  • Claims
  • Microsoft Office
  • negotiation

Summary

Position: Claims Adjuster - Workers Compensation

Duration: 03 months of contract with extension or conversion.

Location: El Dorado Hills, CA

PRIMARY PURPOSE: 

  • To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

 

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

  • Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
  • Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
  • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
  • Manages subrogation of claims and negotiates settlements.
  • Communicates claim action with claimant and client.
  • Ensures claim files are properly documented and claims coding is correct.
  • May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
  • Maintains professional client relationships.
  • ADDITIONAL FUNCTIONS and RESPONSIBILITIES
  • Performs other duties as assigned.
  • Supports the organization's quality program(s).

 

Skills:   

Skills & Knowledge

  • Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business
  • Excellent oral and written communication, including presentation skills
  • PC literate, including Microsoft Office products

Education:         

Education & Licensing

  • Bachelor's degree from an accredited college or university preferred.
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
  • Dice Id: 10509960
  • Position Id: SED2870
  • Posted 1 day ago
Contact the job poster
Sohel Contractor

Sohel Contractor

Talent Acquisition Specialist @ Apidel Technologies
Create job alert
Set job alertNever miss an opportunity! Create an alert based on the job you applied for.

Similar Jobs

El Dorado Hills, California

Yesterday

Easy Apply

Contract, Third Party

Depends on Experience

Remote

13d ago

Easy Apply

Contract

48 - 52

Remote

13d ago

Easy Apply

Contract

50 - 54

Remote

13d ago

Easy Apply

Contract

52 - 56

Search all similar jobs