Immediate Hiring: Workers' Comp CA Licensed Claims Adjuster
Your next career move could be with workwarp as a Workers' Comp CA Licensed Claims Adjuster- Remote - Contract - CA! This role is 100% remote, giving you full control over your work environment. This position requires a strong and diverse skillset in relevant areas to drive success. The compensation for this role is benchmarked at a competitive salary. Â Â 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 Microsoft 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 within established reserve authority levels.
 Review, approve or provide oversight of medical and legal estimates and miscellaneous invoices to determine if reasonable and related to designated claims.
 Negotiate any disputed bills or invoices for resolution.
 Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
 Negotiate settlements in accordance with best practices, client specific handling instructions and state laws, when appropriate.
 Assist in the selection, referral and supervision of designated claim files sent to outside 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 achieve performance goals.
 Good analytic and negotiation skills.
 Ability to cope with job pressures in a constantly changing environment.
 Knowledge of all lower 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 within client service hours for the performance of this position.
 Responsive 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-complex to complex-level claims.
 Strong analytical and problem-solving skills.
 Excellent communication and negotiation abilities.
 Ability to work independently and manage multiple priorities Apply Job! We Encourage You to Apply!Even if you feel you're not a perfect match, we'd still love to hear from you. We are looking for great people to join our friendly team.
Apply Now
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 Microsoft 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 within established reserve authority levels.
 Review, approve or provide oversight of medical and legal estimates and miscellaneous invoices to determine if reasonable and related to designated claims.
 Negotiate any disputed bills or invoices for resolution.
 Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
 Negotiate settlements in accordance with best practices, client specific handling instructions and state laws, when appropriate.
 Assist in the selection, referral and supervision of designated claim files sent to outside 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 achieve performance goals.
 Good analytic and negotiation skills.
 Ability to cope with job pressures in a constantly changing environment.
 Knowledge of all lower 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 within client service hours for the performance of this position.
 Responsive 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-complex to complex-level claims.
 Strong analytical and problem-solving skills.
 Excellent communication and negotiation abilities.
 Ability to work independently and manage multiple priorities Apply Job! We Encourage You to Apply!Even if you feel you're not a perfect match, we'd still love to hear from you. We are looking for great people to join our friendly team.
Apply Now