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Claims Examiner - Workers Compensation

Claims Examiner - Workers Compensation

California StaffingOntario, CA, US
Hace 3 días
Tipo de contrato
  • A tiempo completo
Descripción del trabajo

Claims Examiner - Workers Compensation

Finding a job that fits your lifestyle isn't always easy. That's where Kelly comes in. We're seeking a Claims Examiner - Workers Compensation to work remotely in Ontario, CA. Sound good? Take a closer look below. We're here to help you find something great that works for youso you won't miss a moment of what really matters in your life. Pay Rate : $50 per hour

Why you should apply to be a Claims Examiner - Workers Compensation :

  • Competitive pay rate.
  • Opportunity to work with a reputable company.
  • Convenient dayshift timing.
  • Remote in CA.

What's a typical day as a Claims Examiner - Workers Compensation? You'll :

  • Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
  • Negotiate settlement of claims within designated authority.
  • Calculate and assign timely and appropriate reserves to claims; manage reserve adequacy throughout the life of the claim.
  • Calculate and pay benefits due; approve and make timely claim payments and adjustments; and settle claims within designated authority level.
  • Prepare necessary state filings within statutory limits.
  • Manage the litigation process; ensure timely and cost effective claims resolution.
  • Coordinate vendor referrals for additional investigation and / or litigation management.
  • Use appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
  • Manage claim recoveries, including but not limited to : subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
  • Report claims to the excess carrier; respond to requests of directions in a professional and timely manner.
  • Communicate claim activity and processing with the claimant and the client; maintain professional client relationships.
  • Ensure claim files are properly documented and claims coding is correct.
  • Refer cases as appropriate to supervisor and management.
  • This job might be an outstanding fit if you :

  • High school diploma or GED equivalent is preferred.
  • 3+ years of California WC experience.
  • Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
  • Excellent oral and written communication, including presentation skills.
  • PC literate, including Microsoft Office products.
  • Analytical and interpretive skills.
  • Strong organizational skills.
  • Good interpersonal skills.
  • Excellent negotiation skills.
  • Ability to work in a team environment.
  • Ability to meet or exceed service expectations.
  • As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan.

    About Kelly Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your lifejust ask the 300,000 people we employ each year. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. Kelly Services is proud to be an Equal Employment Opportunity and Affirmative Action employer. We welcome, value, and embrace diversity at all levels and are committed to building a team that is inclusive of a variety of backgrounds, communities, perspectives, and abilities. At Kelly, we believe that the more inclusive we are, the better services we can provide. Requests for accommodation related to our application process can be directed to Kelly's Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment.

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    Examiner • Ontario, CA, US

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