Workers' Compensation Claims Lead Examiner
Automatic Data ProcessingSan Dimas, CA, US30+ days ago
Job type
- Full-time
Job descriptionPossesses professional communication, both written and verbal to facilitate exceptional customer service and resolution for client complaints and issues. Possesses the ability to research complex issues with internal and external parties in a professional, empathetic manner. Ability to adhere to a daily schedule and organize yourself to deal with a high volume of inbounds calls and emails requiring responses within a reasonable period of time. Excellent interpersonal and communication skills and the ability to work independently, discretely, handling information with confidentially. Innovative and successful in implementing best practices for real, measurable results in performance, cost containment and overall efficiency. Understanding of basic leave processes / law, FMLA, and other related subjects. Proficient in the use of Excel, Outlook, Word and other Office suite programs. 7-10 years of workers compensation claims experience working in a client service / customer service environment rich with the use of state-of-the-art predictive modeling, and metrics, data analytic tools and HRIS and claims systems. Requires comprehensive knowledge of CA and western region state workers compensation administration, including applicable local, state and federal laws pertaining to WC insurance programs. Possesses experience evaluating and recommending approval of claims reserves and settlements, designated expenditures and recovery forfeitures as needed. Bachelor's degree or equivalent in experience
Claims Lead Examiner
ADP is hiring a Claims Lead Examiner.
Responsibilities :
- Assist Claims Manager in monitoring the workers compensation program within the ADPTS / PEO structure.
- Review and resolve complaints raised by exterior business partners.
- Identify and track trends with specificity that could be problematic and take steps along with Claims Manager to develop processes to correct.
- Review and provide concurrence to T.P.A. for reserves, settlements, and other items per Special Service Instructions.
- Consistently consult and collaborate with T.P.A. and internal and external business partners.
- Ability to read data specific dashboards to orchestrate evaluation and analysis of claims to meet department and company goals.
- Monitor and ensure qualitative claim handling through T.P.A. and other vendor partners.
- Resolve escalated complaints and / or concerns by clients, risk and safety, H.R. and other internal business partners.
- Promotes interactive process and early return to work programs.
- Perform regular reviews of claims by specified criteria on diary.
- Provide regular reviews and provide feedback and recommendations for resolution of claim files as needed.
Required Skills :
Required Qualifications :
Create a job alert for this search
Compensation Lead • San Dimas, CA, US
Related jobs
At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make lives better.
Our mission is to help people lead healthier, more fulfilling lives...Show moreLast updated: 30+ days ago
Department : Operations – Claims SoCal .We are currently seeking a highly motivated Claims Examiner.This role will report to the Manager - Claims and enable us to continue to scale in the healthcar...Show moreLast updated: 3 days ago
Every person deserves compassion, dignity, and the safety of a place to call home.Homelessness is the largest social and public health crisis in California.
Illumination health + home is a growing n...Show moreLast updated: 8 days ago
Cut N Dry Restoration is on the lookout for a detail-driven, negotiation-savvy professional to join our fast-paced, mission-focused team as a.
If you're someone who thrives on turning challenges int...Show moreLast updated: 30+ days ago
Seeking experienced investigators with commercial or personal lines experience, with multi-lines preferred to include AOE / COE, Auto, and Homeowners.
SIU experience is highly desired, but not require...Show moreLast updated: 23 days ago
Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 7 hours ago Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 7 hours ago 
The Insurance Claims Examiner is responsible for overseeing insurance claims and ensuring the company maintains adequate insurance coverage for all multi-family housing communities.This role combin...Show moreLast updated: 30+ days ago
Workers Compensation Adjuster III Summary : .Reports directly to the unit Claims Supervisor and may be called upon to provide technical backup in the absence of the Claims Supervisor.In accorda...Show moreLast updated: 30+ days ago
Workers’ Compensation Defense Attorney – Remote (California).K–$200K Base + Bonus | 5–10+ Years Experience | .K–$200K base salary + bonus potential.Full support s...Show moreLast updated: 30+ days ago
The General Liability Claims Examiner II role is to investigate and resolve liability, auto, property and first party claims.
This position resolves claims in accordance with state specific guidelin...Show moreLast updated: 30+ days ago At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make lives better.
Our mission is to help people lead healthier, more fulfilling lives...Show moreLast updated: 30+ days ago Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 7 hours ago The Senior General Liability Examiner conducts all work activities for managing basic to high exposure / complex claims, including investigation and the timely resolution of cases in alignment with r...Show moreLast updated: 4 days ago At LifeStance Health, we believe in a truly healthy society where mental and physical healthcare are unified to make lives better.
Our mission is to help people lead healthier, more fulfilling lives...Show moreLast updated: 30+ days ago Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 7 hours ago Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 7 hours ago 
Since 1978, TCI Transportation has been dedicated to serving our clients in the only way we know how – with integrity, passion, and ingenuity.
We’ve spent the past 4 decades expanding our locations ...Show moreLast updated: 9 days ago
First Rescue Ambulance is seeking on on-site ambulance biller.Must be able to work on-site at our Irwindale location.Ambulance billing experience is required.
Partners with Operations to resolve iss...Show moreLast updated: 30+ days ago Earn at least $620 driving with Uber when you complete your first 64 trips in 30 days.Driving is an easy way to boost your income while maintaining the flexibility your schedule requires (gig, part...Show moreLast updated: 7 hours ago
- Promoted
Licensed Mental Health Therapist (LMFT, LCSW, LPCC) - Perris, CA
LifeStance HealthPerris, CA, USFull-time
Claims Examiner I
Astrana Health, Inc.Monterey Park, California, USFull-time
Quick Apply
Claims Specialist
Illumination Health + HomeSanta Ana, CA, USFull-time
Quick Apply
Insurance Claims Advocate
Cut N Dry RestorationUpland, CA, USAFull-time
Quick Apply
Claims Investigator - Experienced
Command InvestigationsOrange County, CA, USFull-time
Quick Apply
- Promoted
- New!
Flexible $ : Earn At Least $620 For Your First 64 Trips, Guaranteed.
UberOak Hills, CA, United StatesFull-time +1
- Promoted
- New!
Drive with Uber : Earn at least $620 when you complete 64 trips.
UberPhelan, CA, United StatesFull-time +1
Insurance Claims Examiner / Coordinator
Positive InvestmentsArcadia, CA, USAFull-time
Quick Apply
Workers Compensation Adjuster - Orange
Intercare InsuranceOrange, CA, USFull-time
Quick Apply
Worker's Compensation Defense
GpacOrange, California, United StatesFull-time
Quick Apply
General Liability Claims Examiner II
Panda Restaurant GroupRosemead, CA, USFull-time +1
- Promoted
Licensed Mental Health Therapist (LMFT, LCSW, LPCC) - Mt Baldy, CA
LifeStance HealthMount Baldy, CA, USFull-time
- Promoted
- New!
Earn At Least $620 For Your First 64 Trips, Guaranteed.
UberPhelan, CA, United StatesFull-time +1
Senior General Liability Examiner
Panda Restaurant GroupRosemead, CA, USFull-time +1
- Promoted
Licensed Mental Health Therapist (LMFT, LCSW, LPCC) - Wildomar, CA
LifeStance HealthWildomar, CA, USFull-time
- Promoted
- New!
Quick Earnings : Earn At Least $620 For Your First 64 Trips, Guaranteed.
UberLytle Creek, CA, United StatesFull-time +1
- Promoted
- New!
Choose your schedule - Earn At Least $620 For Your First 64 Trips, Guaranteed.
UberLytle Creek, CA, United StatesFull-time +1
Claims Administrator
TCI TransportationFontana, California, .USFull-time
Quick Apply
Ambulance Biller
First Rescue AmbulanceIrwindale, CA, USAFull-time
Quick Apply
- Promoted
- New!
Flexible schedule - Earn at least $620 by driving 64 trips with Uber
UberLytle Creek, CA, United StatesFull-time +1