Senior Workers’ Comp Claims Examiner - Flexible Remote CA

Athens Administrators, Inc.; Concord (CA); Hybride; USD 70 000 - 110 000; Plein temps

Avantages offerts par ce poste

Medical benefits

401k plan

Résumé du poste

Athens Administrators has an immediate need for a full-time Senior Claims Examiner - Flex to support our workers' compensation offices. This role can be located anywhere in California, with weekly in-office days required for those within 26 miles of the Concord, CA or Orange, CA offices, on a day determined by their supervisor.

The remaining days can be worked remotely if technical requirements are met, and the employee resides in California.

Qualifications

• High School Diploma or GED required; AA/AS or BA/BS preferred.
• Must possess a current Experienced Indemnity Claims Adjuster designation issued by an insurer (CA Code).
• 3+ years recent workers' compensation claims handling experience.
• At least 5 years of workers' compensation claims experience preferred.
• Solid knowledge of workers' comp laws, policies, and procedures.
• Proficiency in Microsoft Office Suite; ability to learn additional programs.
• Strong verbal and written communication with attention to detail.

Responsabilités

• Establish contact with employer to review issues
• Respond to inquiries from employer, employee, doctors, and attorneys
• Establish and maintain appropriate reserves
• Review legal correspondence and medical reports
• Evaluate and approve medical procedures and treatment
• Administer benefits and ensure appropriateness of all payments
• Investigate coverage, liability, and monetary value of claim
• Review medical and legal bills for appropriateness
• Negotiate settlements
• Prepare reports to clients
• Close claims and support litigation

Connaissances

WC claims handling

Negotiation

Communication skills

Microsoft Office

Attention to detail

Legal terminology

Formation

High School Diploma

AA/AS or BA/BS preferred

Experienced Indemnity Claims Adjuster designation

Outils

Microsoft Office Suite

Description du poste

Athens Administrators has an immediate need for a full-time Senior Claims Examiner - Flex to support our workers' compensation offices. This role can be located anywhere in California, with weekly in-office days required for those within 26 miles of the Concord, CA or Orange, CA offices, on a day determined by their supervisor.

The remaining days can be worked remotely if technical requirements are met, and the employee resides in California.