California Workers’ Comp Claims Specialist II

WorkCompCentral, Inc.; California (MO); On-site; USD 57,000 - 95,000; Full time

Job summary

WorkCompCentral, Inc. is seeking an intermediate claim handler with California experience to manage moderately difficult workers’ compensation claims. You will verify coverage, assess compensability, and determine causality to ensure appropriate benefit payments.

You will also facilitate returns to work and establish reserves within authorized limits. The role involves negotiating settlements and coordinating with managers on complex files.

Qualifications

• Requires knowledge of workers’ compensation laws and regulations
• Strong communication and negotiation abilities
• Ability to manage multiple priorities and deadlines, with attention to detail

Responsibilities

• Verifies workers’ compensation coverage for employers and injured employees
• Determines compensability under workers’ compensation through investigation
• Assesses causal relationship to ensure proper payment of benefits
• Facilitates return to work for the injured employee
• Establishes reserves within authority based on claim exposure
• Manages medical bills for related claims and ensures treatment links
• Concludes and closes files to meet performance standards and comply with laws
• Negotiates settlements with attorneys or parties within authority

Skills

Communication skills

Negotiation

Decision making

Analytical thinking

Multitasking

Education

Bachelor’s degree in related field

3 years workers’ compensation claims experience

AF Group Claims Representative I experience

Tools

Company standard software

Job description

WorkCompCentral, Inc. is seeking an intermediate claim handler with California experience to manage moderately difficult workers’ compensation claims. You will verify coverage, assess compensability, and determine causality to ensure appropriate benefit payments.

You will also facilitate returns to work and establish reserves within authorized limits. The role involves negotiating settlements and coordinating with managers on complex files.