Workers Compensation Claims Examiner IIISacramento CA

Canon Recruiting Group; Los Angeles (CA); Remote; USD 85,000 - 95,000; Full time

Job summary

An established industry player is seeking a Workers Compensation Claims Examiner III for a fully remote role. In this dynamic position, you will manage a caseload of complex indemnity claims, ensuring compliance with state laws and best practices. Your expertise will be crucial in conducting investigations, communicating with various stakeholders, and authorizing medical treatments. This role offers a competitive salary range and the opportunity to work in a diverse and inclusive environment. If you are passionate about claims management and thrive in a proactive role, this is the perfect opportunity for you.

Benefits

Health Care Plans

401(k) Savings Plans

Qualifications

• SIP Certification is required to manage complex indemnity claims.
• Strong communication and organizational skills are essential.

Responsibilities

• Manage a caseload of 130 indemnity claims, ensuring timely investigations.
• Communicate with claimants and attorneys to resolve claims efficiently.

Skills

Claims Management

Investigative Skills

Communication Skills

Organizational Skills

Education

SIP Certification

Tools

Claims Management Software

Microsoft Office

Job description

POSITION: Workers Compensation Claims Examiner III

FULLTIME

LOCATION: Fully Remote

SCHEDULE: Monday-Friday

PAY RANGE: $85-95K/yr.
(Exact compensation may vary based on skills, experience, and location. Base pay information is based on market location.)

JOB DESCRIPTION:

• Effectively manages a caseload of indemnity claim files, including very complex and litigated claims.
• The caseload will be between 130 workers’ compensation files. It claims and administers benefits for medical treatment and medical billing.

JOB RESPONSIBILITIES:

• Effectively manages a caseload of indemnity claim files, including very complex and litigated claims.
• Initiates and conducts investigations in a timely manner.
• Determines compensability of claims and administers benefits based upon state law and Best Practices for claim handling.
• Manages medical treatment and medical billing, authorizing as appropriate.
• Refers cases to outside defense counsel and participates in litigated matters.
• Communicates with claimants, attorneys, providers, and vendors regarding claims issues.
• Works in an organized and proactive manner.
• Computes and sets reserves within Company guidelines.
• Settles and/or finalizes all claims and obtains authority as designated.
• Maintains diary system for case review and documents file to reflect the status and work being performed on the file, including a plan of action.
• Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety-related concerns.

REQUIRED QUALIFICATIONS: SIP Certification

WORKING CONDITIONS:

• May on occasion be exposed to loud sounds and distracting noise levels, such as from office equipment.
• The ability to lift up to 30lbs.
• Use of computers and technology.

Canon Recruiting is committed to a diverse and inclusive workplace. Canon Recruiting is an equal opportunity employer and does not discriminate on the basis of race, national origin, gender, gender identity, sexual orientation, protected veteran status, disability, age, or other legally protected status.

The pay range for this position is listed above. Base pay information is based on market location.

We will consider for employment qualified applicants with arrest and conviction records. Our range of benefits may include health care and 401(k) savings plans.

For individuals with disabilities who would like to request an accommodation, please email [e-mail].