Careermilard | Distributed Workers' Comp CA Licensed Claims

careermilard has an opening for a dedicated Workers' Comp CA Licensed Claims Adjuster- Remote - Contract - CA! This is an exciting Remote opportunity with an immediate start. This position requires a strong skillset in relevant areas. This position comes with a salary of Competitive salary.

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!