Claims Adjuster - Workers Compensation - Remote / Telecommute

We are looking for Claims Adjuster - Workers Compensation - Remote / Telecommute for our client in El Dorado Hills CA.

Job Title: Claims Adjuster - Workers Compensation - Remote / Telecommute

Job Location: El Dorado Hills CA

Job Type: Contract

Job Overview:

Pay Range: $32.85hr - $37.85hr

Requirement/Must Have:

• 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.
• PC literate, including Microsoft Office products.
• Analytical and interpretive skills.
• Strong organizational skill.
• Excellent negotiation skills.
• Ability to work in a team environment.
• Ability to meet or exceed Service Expectations.

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.
• Performs other duties as assigned.
• Supports the organization s quality program(s).

Skills:

• Workers Compensation Claims Adjudication.
• Subrogation Negotiation.
• Settlement Negotiation.
• Microsoft Office.
• Strong verbal and written communication skills.
• Excellent communication and presentation skills.
• Good interpersonal skills.

Qualification And Education:

• Bachelor s degree from an accredited college or university preferred.

• Medical, Dental, and Vision Insurance
• 401(k) Retirement Plan
• Health Savings Account (HSA)
• Disability Insurance (Short-Term and Long-Term)
• Life and AD&D Insurance
• Paid Sick Leave (where required by applicable state or local law)
• Supplemental Insurance Plans
• Identity Theft Protection
• Pet Insurance
• Employee Wellness Programs
• Employee Assistance Program (EAP)
• Career Growth and Professional Development Opportunities