Senior Workers' Comp Claims Examiner
Senior Workers' Comp Claims Examiner
Fresno, CA - San Leandro, CA
Job Type:Temp
Full-Time/ Part-Time:Full-Time
Duration of Assignment:Indefinite
Diploma/Degree Required:High School
Salary/ Pay-Rate:$50,000.00 - $68,000.00 Annual
Job Description/ Qualifications:Candidates must possess strong problem solving abilities. At least five years experience required.
Specific job duties and responsibilities:
~Actively manage case load of lost time cases in order to return to work our customers' most valuable resource, their employees, as soon as medically reasonable. Many cases involve complex medical, legal, and vocational rehabilitation issues.
~Manage diary and complete tasks to ensure that cases move to the best financial outcome and timely resolution. This includes properly scrutinizing both the propriety of medical treatment.
~Properly set claim reserves.
~Identify, assign, and coordinate the assignment and coordination of expertise resources to assist in case resolution.
~Responsible for telephone calls from various parties (insured, claimant, medical facilities, et.).
The qualified candidate will have the following:
~Good business acumen (i.e. understand how an insurance company works and makes money).
~Knowledge of workers' compensation law in California, particularly as it applies to compensability, causal relationship, and return to work.
~Strong understanding of medical terminology, medical diagnoses, and medical procedures.
~Ability to manage return to work; including setting and managing goals with employers, doctors, and injured workers.
~Innovative in assisting injured workers in finding alternative employment opportunities.
~Knowledge of financial management, including the proper setting of reserves and evaluation for settlement.
~Ability to articulate the financial value of your work at multiple responsibility levels inside our clients' business which may include the CEO.
~Strong litigation management skills and excellent knowledge of applicable case law.
~Experience in managing rehabilitation issues and identifying and implementing innovative rehabilitation programs.
~Be able to travel throughout the state, sometimes overnight, approximately 15% of the time.
~Must possess a strong customer focus.
~Strong negotiation skills is a must.
~Ability to prioritze workload, and handle multiple tasks.
~Excellent evaluation and strategic skills is required.
~Must work independently and demonstrate the ability to exercise sound judgement.
~Ability to work well in a team environment.
~Excellent listening skills.
~Polished and professional written and verbal communication skills.
~Demonstrated written and verbal ability is required.
~Ability to read and write Spanish fluently is strongly preferred but not required.
~Proficiency in MS Office Suite and other field applications.
Please contact Rita Radics if interests and qualifications apply.
Salary: DOE.
Contact Information:
Adecco Fresno Finance Branch
776 E. Shaw Avenue
Fresno, California 93710
Phone: 559-224-1107
Fax: 559-224-2614
E-mail: divya.talajia@adeccona.com
Job ID:025103
Keywords:
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Insurance 
