Senior Workers' Compensation Claims Adjuster

InterMed Cost Containment Services; Glendale (CA); On-site; USD 65,000 - 90,000; Full time

Job summary

AvonRisk is seeking a claims professional to manage a portfolio of workers’ compensation cases across California, ensuring timely contact and thorough documentation. You will work with the medical team to promote early return-to-work while maintaining compliance with state laws.

The role requires sharp case management, strong communication, and a meticulous approach to reserving and bill review. Join a team focused on rigorous training and collaborative problem solving.

Qualifications

• Experience handling workers' compensation claims in California.
• Ability to document case facts and maintain accurate records.
• Strong understanding of case management workflows and timelines.

Responsibilities

• Perform a three-point contact on all new losses within 24 hours of receipt.
• Document ongoing case facts and information for compensability and disability.
• Maintain up-to-date action plans for indemnity claims.
• Collaborate with medical case managers to maximize early return-to-work.
• Refer cases with suspected fraud to the SIU.
• Pursue subrogation and apportionment when applicable.
• Ensure claim files comply with statutes and contracts.
• Review vocational rehabilitation plans and approve when appropriate.
• Establish and monitor monetary reserves within authority limits.
• Review medical bills for appropriateness before payment.
• Provide courteous, professional service representing AvonRisk.
• Respond to messages within 24 hours and inquiries within one week.
• Utilize knowledge of the California Labor Code as it pertains to workers' comp.

Skills

Caseload management

Case documentation

Communication skills

Legal knowledge

Fraud detection

Job description

AvonRisk is seeking a claims professional to manage a portfolio of workers’ compensation cases across California, ensuring timely contact and thorough documentation. You will work with the medical team to promote early return-to-work while maintaining compliance with state laws.

The role requires sharp case management, strong communication, and a meticulous approach to reserving and bill review. Join a team focused on rigorous training and collaborative problem solving.