Senior Workers’ Comp Claims Adjuster – Hybrid

Intercare Holdings Insurance Services; United States; Hybrid; USD 41,000 - 55,000; Full time

Job summary

AvonRisk, a leading risk management organization, seeks a claims examiner to manage an assigned inventory of claim files with timely action on new losses and thorough fact gathering. You will coordinate with medical case managers and maintain reserves per policy guidelines.

The role is hybrid with three days in office at Glendale or Orange; remote candidates will not be considered. Salary ranges from $30 to $40 per hour, requiring a bachelor’s degree and 3–5 years of related experience.

Qualifications

• Bachelor’s degree preferred.
• 3-5 years related experience & training; 5 years without SIP certificate.

Responsibilities

• Perform a three-point contact on all new losses within 24 hours of receipt of the claim.
• Gather evidence regarding case facts to establish compensability and disability needs.
• Maintain up-to-date reserve plans and action items for each claim.
• Collaborate with medical case manager to maximize early return to work potential.
• Refer suspected fraud cases to SIU and pursue subrogation when appropriate.
• Ensure claims are handled in accordance with statutes and company guidelines.
• Oversee litigation management and related activities.

Skills

Problem Solving

Customer Service

Interpersonal

Team Work

Education

Bachelor’s degree preferred

3-5 years related experience & training

Job description

AvonRisk, a leading risk management organization, seeks a claims examiner to manage an assigned inventory of claim files with timely action on new losses and thorough fact gathering. You will coordinate with medical case managers and maintain reserves per policy guidelines.

The role is hybrid with three days in office at Glendale or Orange; remote candidates will not be considered. Salary ranges from $30 to $40 per hour, requiring a bachelor’s degree and 3–5 years of related experience.