Claims Adjuster II - CA

Employers Holdings; California (MO); Hybrid; USD 50,000 - 75,000; Full time

Job summary

An innovative firm is seeking a dedicated Claims Adjuster II to manage workers' compensation claims in a fully remote role. This position offers a unique opportunity to leverage your expertise in claims adjusting while working from the comfort of your home. You will be responsible for the timely and accurate management of claims, ensuring compliance with laws and company policies. Join a dynamic team that values integrity and collaboration, and enjoy a comprehensive benefits package that supports your career growth. If you thrive in a fast-paced environment and are passionate about delivering exceptional service, this role is perfect for you.

Qualifications

• 2-5 years of work comp claims adjusting or insurance experience required.
• Self-motivated with excellent analytical and decision-making skills.

Responsibilities

• Manage workers’ compensation claims with moderate medical and indemnity exposure.
• Provide timely customer service and maintain professional communications.

Skills

Communication Skills

Customer Service

Analytical Skills

Problem-Solving

Knowledge of Workers’ Compensation Laws

Education

High School Diploma

Bachelor’s Degree

Job description

Join to apply for the Claims Adjuster II - CA role at EMPLOYERS

Workers’ Compensation Claims Adjuster II - California | 100% Remote Opportunity

General Summary

The Work comp Claims Adjuster II is responsible for the timely and accurate management of workers’ compensation claims with moderate medical and indemnity benefit exposure, including litigation.

This opportunity requires work comp claims adjuster experience in California.

Essential Duties And Responsibilities

1. Completes initial contacts to obtain necessary additional information, verify coverage, determine compensability, and develop a plan of action. Completes and maintains accurate claim system data.
2. Analyzes case facts to establish timely and accurate case reserves using knowledge of medical disabilities and related costs, as well as judgment of extent of disability.
3. Provides timely and appropriate customer service within established best practices. Maintains ongoing professional communications with all internal and external customers.
4. Accurately evaluates and pays benefits in compliance with statutory and company procedures and guidelines. Files appropriate state forms, as needed.
5. Proactively coordinates and monitors medical treatment to continue to move the claim forward. Uses resources, internal and external, to contain costs and manage exposure.
6. Reviews and analyzes legal exposures. Collaborates with defense attorneys to manage legal issues. Proactively mitigates exposure to litigation, prices up claims for settlement, and works within authority to resolve claims.
7. Regularly reviews caseload and proactively takes action to guide claims efficiently and effectively to closure.
8. Other duties as assigned.

Requirements

1. 2 - 5 years of work comp claims adjusting or insurance experience.
2. Excellent communication and customer service skills and knowledge of an imaging environment.
3. Demonstrated knowledge of workers’ compensation laws and ability to adhere to statutes, regulations, and company policies and practices, as well as related claim management procedures/protocols.
4. Self-motivated with excellent analytical, problem-solving, and decision-making skills. Strong ability to multi-task and prioritize.
5. High school diploma or equivalent required.
6. Equivalent combinations of education and experience may be considered.

Certification

1. If state certification or license is required, must meet requirements and obtain certification within the state-mandated timeframe and maintain any required license through continuing education.
2. WCCP, AIC, ARM, CPCU, or other insurance certification preferred.

Education

1. Bachelor’s degree or equivalent business experience preferred.

Work Environment/Physical Demands

• This role is REMOTE friendly, and only open to candidates currently located in the United States.
• It requires a suitable space that provides a private and quiet workplace.
• Expected Work Hours: Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.
• Travel: May be required to travel to off-site location(s) to attend meetings, as necessary.

Salary Range

$50,000-$75,000 and a comprehensive benefits package. Please follow the link for details: https://www.employers.com/careers/our-benefits-and-perks/

About EMPLOYERS

We are a dynamic, fast-growing provider of workers' compensation insurance and services, seeking goal-oriented individuals willing to contribute their ideas! We offer a positive, challenging work environment and opportunities for career growth as we expand our business in innovative ways.

Headquartered in Nevada, EMPLOYERS values its employees across the U.S. and is known for quality service and an exemplary work environment. Our core values include Integrity, Customer Focus, Collaboration, Initiative, Accountability, Innovation, and Personal Fulfillment.

Join us and discover an energetic environment that fosters achievement. As “America’s small business insurance specialist,” we have the resources, reputation, and nationwide presence to enrich your career.