Remotery

Workers Compensation Claims Examiner, CA/NV License Required

Posted 14 hours ago

This is a fully remote position, open to applicants in California, +2 more states.

📋 Description

• Evaluate workers' compensation claims on behalf of clients to ascertain benefits owed.

• Guarantee the continuous adjudication of claims in line with service expectations, industry standards, and client service obligations.

• Review and manage claims through action plans aimed at achieving appropriate and timely resolutions.

• Conduct investigations and gather information to assess claim exposure.

• Negotiate settlements within the established authority limits.

• Communicate claim activities and processing updates with claimants and clients.

• Report claims to the excess insurance carrier.

• Respond to requests for guidance in a professional and timely manner.


⛳️ Requirements

• High School Diploma or GED is mandatory.

• A bachelor's degree from an accredited institution is preferred.

• Relevant professional certification related to the line of business is preferred.

• Minimum of 5 years of claims management experience or a comparable mix of education and experience is required.

• Must hold a license in California or Nevada.

• Strong analytical and conceptual thinking skills.

• Excellent judgment, problem-solving, troubleshooting, and analytical abilities, along with discretion.

• Capable of managing work-related stress and juggling multiple priorities at once.

• Ability to meet deadlines effectively.

• Proficient in computer keyboarding.

• Capable of hearing, seeing, and communicating effectively.


🏝️ Benefits

• Flexible work schedule.

• Referral incentive program.

• Opportunities for career development and advancement.

• Medical, dental, and vision insurance.

• 401(k) plan with matching contributions starting on day one.

• Paid time off (PTO).

• Disability and life insurance coverage.

• Employee assistance programs.

• Flexible spending accounts or health savings accounts.

• Additional optional benefits available.

• Reasonable accommodations provided where applicable.

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