Workers Compensation Claims Examiner III
Workers Compensation Claims Examiner III Job Details Level reputed company Job Location Signal Hill Office - Signal Hill, CARemote Type Fully Remote Position Type Temporary Education Level High School Diploma or GED Salary reputed company $93,600.00 - $104,000.00 Salary/year Travel Percentage None Job Shift Day Job Category Insurance Workers Compensation Claims Examiner III _reputed company Please complete reputed company of the questions, information and sign your application at the end. This can be a remote or hybrid at any of our California offices. The position requires the employee to be bilingual English/ Spanish. Must have a CA SIP and reputed company in California. POSITION SUMMARY: Under minimal supervision manages reputed company aspects of indemnity claims handling from inception to conclusion reputed company established authority and guidelines. This position requires considerable interaction with clients, claimants on the phone, and with management, other Claims Examiners, and other reputed company staff in the office; therefore consistently being at work in the office, in a timely manner, is inherently required of this position. DUTIES AND RESPONSIBILITIES: Effectively manages a caseload of 150 to 180 workers compensation files, including reputed company reputed company claims.* Initiates and conducts investigation in a timely manner.* Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.* Manages medical treatment and medical billing, authorizing as appropriate.* Refers cases to reputed company defense counsel. Directs and manages as appropriate.* Communicates with claimants, providers and vendors regarding claims issues.* Computes and set reserves reputed company Company guidelines. Limits are larger than those allowed for Claims Examiner I and Claims Examiner II.* Settles and/or finalize reputed company claims and obtains authority as designated.* Maintains diary system for case review and documents file to reflect the status and work being performed on the file.* Communicates appropriate information promptly to the client to resolve claims reputed company, including any injury trends or other safety reputed company concerns.* Adheres to reputed company Company policies and procedures.* Conducts file reviews independently.* Other duties as assigned. Essential job function.
Qualifications
Education/Experience: Bachelors degree in reputed company field (preferred); three (3) or more years reputed company experience; or equivalent combination of education and experience. Knowledge, Skills and Abilities: Technical knowledge of statutory regulations and medical terminology. Analytical skills. Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff. Ability to interact with persons at reputed company reputed company in the business environment. Ability to independently and effectively manage reputed company reputed company claims. Proficient in Word and reputed company (preferred). Other Qualifications: California SIP Certifications required Apply Job!