Workers' Compensation Claims Representative

This is a fully remote position, open to applicants in California.

📋 Description

• Assess compensability and/or coverage concerns for lost time workers' compensation claims

• Efficiently oversee a portfolio of lost time claims across various jurisdictions

• Negotiate and facilitate settlements under management's supervision

• Collect medical and factual evidence to evaluate compensability

• Supervise external investigations and manage litigation files within authorized limits

• Coordinate and maintain communication with claimants and/or their legal representatives, outside investigators, and rehabilitation specialists, along with regular interaction with insured clients, account representatives, and healthcare providers

⛳️ Requirements

• At least 3 years of relevant experience required

• Experience in managing claims across multiple jurisdictions

• A Bachelor's degree is required

• SIP Certification is mandatory

• Experience with carriers is preferred

• Experience in managing lost time or litigated claims is essential

• Knowledge of medical terminology is necessary

• Proven ability to demonstrate strong organizational, problem-solving, negotiation, and conflict resolution skills

• Exceptional verbal and written communication skills are required

🏝️ Benefits

• Medical (PPO/HDHP), vision, disability, and life insurance

• Enhanced dental plan including orthodontia coverage, in addition to a standard plan

• Generous PTO plan for all eligible employees

• Paid company holidays along with 4 floating holidays

• Paid parental leave

• Employee Retirement Savings Plan/401(k) with company match and immediate vesting

• Education Assistance Program offering 100% upfront tuition reimbursement after 6 months of service for approved degree programs

• Service Recognition Program providing a monetary award for vacation use every 5 years of employment

• Wellness Initiatives that feature Fitness Center and Weight Watchers Reimbursement programs

• Voluntary benefits including accident, critical illness, and hospital indemnity

• Employee discount and rewards program on travel, tickets, electronics, home goods, and more