Workers' Compensation Claims Examiner

Ultimate Staffing; San Diego (CA); Hybrid; USD 52.000 - 62.000; Teilzeit

Zusammenfassung

Ultimate Staffing is seeking an experienced Workers' Compensation Claims Examiner in San Diego, CA. The role is hybrid with remote Mondays and Fridays and in-office Tue–Thu, with the possibility to convert or extend the temporary assignment. Pay is $38-$45/hr DOE, 37.5 hours per week.

The examiner will manage claims through the full lifecycle, investigate compensability, establish reserves, and coordinate with workers, employers, attorneys, and medical providers to achieve favorable resolutions.

Qualifikationen

• 5+ years of workers' compensation claims handling experience.
• Strong understanding of workers' compensation laws, regulations, and claims management practices.
• Experience managing indemnity claims preferred.
• Excellent communication, organizational, and problem-solving skills.
• Ability to manage multiple priorities in a fast-paced environment.
• Proficiency with Microsoft Office applications.

Aufgaben

• Manage a caseload of workers' compensation claims through the full claim lifecycle.
• Investigate claims and determine compensability.
• Establish and manage claim reserves.
• Coordinate with injured workers, employers, attorneys, medical providers, and other stakeholders.
• Develop action plans and strategies to move claims toward resolution.
• Facilitate return-to-work and modified duty programs.
• Review and authorize claim payments within authority limits.
• Maintain timely and accurate claim documentation while ensuring regulatory compliance.

Kenntnisse

Claims handling

Regulations knowledge

Indemnity claims

Communication

Multitasking

MS Office

Tools

Microsoft Office

Jobbeschreibung

If you're looking for a flexible opportunity with a strong team environment and the ability to make an impact throughout the claims process, we'd love to hear from you.

Workers' Compensation Claims Examiner

Location: San Diego, CA (Hybrid) | Remote Considered

Employment Type: Temporary: 4-6 months (Possibility for extension or conversion based on business needs)

Pay: $38-$45/hr. DOE

Schedule: 37.5 hours/week | Flexible Schedule

We're seeking an experienced Workers' Compensation Claims Examiner to join a collaborative team managing workers' compensation claims from investigation through resolution. This role offers flexibility, a manageable 37.5-hour workweek, and the opportunity to work with a variety of stakeholders to achieve positive claim outcomes.

Schedule & Work Arrangement

• 37.5-hour workweek
• Flexible schedule
• Hybrid schedule for local employees:
  • Remote Mondays and Fridays
  • In-office Tuesdays, Wednesdays, and Thursdays
• Fully remote candidates may be considered if located outside the San Diego area

Responsibilities

• Manage a caseload of workers' compensation claims through the full claim lifecycle
• Investigate claims and determine compensability
• Establish and manage claim reserves
• Coordinate with injured workers, employers, attorneys, medical providers, and other stakeholders
• Develop action plans and strategies to move claims toward resolution
• Facilitate return-to-work and modified duty programs
• Review and authorize claim payments within authority limits
• Maintain timely and accurate claim documentation while ensuring regulatory compliance

Qualifications

• 5+ years of workers' compensation claims handling experience
• Strong understanding of workers' compensation laws, regulations, and claims management practices
• Experience managing indemnity claims preferred
• Excellent communication, organizational, and problem-solving skills
• Ability to manage multiple priorities in a fast-paced environment
• Proficiency with Microsoft Office applications

Desired Skills and Experience

• Workers' Compensation Claims
• Claims Management
• Claims Investigation
• Claims Adjudication
• Indemnity Claims
• Reserve Analysis
• Return-to-Work Programs
• Claims Resolution
• Settlement Negotiation
• Subrogation
• Benefit Administration
• Medical Case Management
• Workers' Compensation Regulations
• Litigation Management
• Risk Management
• Client Relations
• Insurance Claims
• Claims Documentation
• Vendor Management
• Customer Service

All qualified applicants will receive consideration for employment without regard to race, color, national origin, age, ancestry, religion, sex, sexual orientation, gender identity, gender expression, marital status, disability, medical condition, genetic information, pregnancy, or military or veteran status. We consider all qualified applicants, including those with criminal histories, in a manner consistent with state and local laws, including the California Fair Chance Act, City of Los Angeles' Fair Chance Initiative for Hiring Ordinance, Los Angeles County Fair Chance Ordinance, and San Francisco Fair Chance Ordinance.