Workers’ Compensation Claims Representative - Hybrid - Fresno, CA

Insurance Relief; Fresno (CA); On-site; USD 70,000 - 90,000; Full time

Benefits offered by this job

Comprehensive benefits package

401(k) plan

Generous Paid Time Off

Job summary

A reputable insurance agency in Fresno, CA, is seeking an experienced Workers' Compensation Claims Representative. This full-time position involves investigating and evaluating claims while ensuring proper documentation. The ideal candidate will have 3-5 years of claims experience, strong knowledge of compliance guidelines, and excellent customer service skills. Generous benefits include a salary range of $70,000 – $90,000 and opportunities for professional growth.

Qualifications

• 3-5 years of experience in workers' compensation claims.
• Strong knowledge of Worker's Compensation guidelines.

Responsibilities

• Investigate and evaluate claims.
• Ensure proper documentation and coding.
• Identify signs of fraud and pursue subrogation.

Skills

Workers' compensation claims experience

Knowledge of Medicare coding

Customer service skills

Database management

Education

Certifications as WCCA and WCCP

Tools

Microsoft Office

Job description

Base Pay Range

$70,000.00/yr – $90,000.00/yr

Join a well-established insurance agency with a 30‑year legacy and a powerful commitment to ethical, honest insurance solutions. They are actively seeking an experienced Workers' Compensation Claims Representative! You will drive success by investigating and evaluating claims, expediting payments, and ensuring proper documentation. Grow your expertise with a team ready to invest in your long‑term professional development.

What’s in it for you?

• Earn an annual salary of $70,000 – $90,000+, depending on your experience
• Comprehensive benefits package including Medical, Dental, and Vision insurance
• 401(k) plan
• Generous Paid Time Off (PTO) and paid company holidays

What we need from you:

• 3-5+ years of experience in workers' compensation claims
• Certifications as a Workers Compensation Claims Administrative (WCCA) and Workers Compensation Claims Professional (WCCP) are preferred but not required
• Knowledge of Worker's Compensation guidelines, Medicare coding, and compliance obligations.
• Microsoft Office and other database management systems

The Position:

• Assisting with new claims from opening until satisfactory completion, evidence, and fact-gathering surrounding claims
• Ensuring claims coding is true and accurate
• Claim files must be accurately recorded in the system
• Assuring all claims have a workable plan of action
• Reviewing billing summaries
• Identifying any signs of fraud and making proper referrals for further investigation
• Pursue subrogation when necessary and offer superior customer service to all parties involved

Why Insurance Relief™?

As a businessperson in the insurance industry, it is an advantage to partner with a staffing expert and ally who understands your unique skills and needs. With vast experience in the insurance arena, Insurance Relief™ works with brokers, carriers, and third‑party administrators to locate and place the best people for positions ranging from entry‑level to senior management. We invest the time to truly understand what you want to accomplish and then do our best to find meaningful opportunities.

Insurance Relief™ provides ample opportunities for you to put your skills to work so if this position is not quite the fit for you please give us a call to hear about all of the other opportunities we have available.

Senior Level

Seniority level: Associate

Employment Type

Employment type: Full‑time

Job Function

Job function: Administrative and Management

Industries: Insurance and Insurance Agencies and Brokerages

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