Claims Adjuster - California Workers' Compensation

2 days ago

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Method Workers' Comp

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Workers Compensation • Expert Underwriting • Exceptional Customer Service • Extensive Appetite • Challenging Work Comp

51 - 200

Description

• Analyze workers' compensation claims to determine benefits due • Ensure ongoing adjudication of claims within service expectations and best practices • Investigate claims with minimal supervision, reviewing reports and medical records • Ensure compliance of claims handling requirements with legal regulations • Exercise independent judgment in evaluating and managing claims • Evaluate exposure of claims and manage medical treatment processes • Communicate claim activity to relevant stakeholders • Prepare state filings within statutory regulations • Calculate average weekly wage and indemnity benefits owed • Manage claim recoveries and notify management of significant exposure issues • Maintain knowledge of jurisdictional requirements and case law

Requirements

• In-depth knowledge of workers' compensation insurance principles and laws, as well as cost containment principles • Strong analytical, critical thinking, and problem-solving skills • Detail-oriented with the ability to work in a team environment • Excellent customer service, written and verbal communication skills • Ability to prioritize and balance multiple projects simultaneously • Results-driven, proactive, and able to work autonomously • Ability to exercise discretion and independent judgment • Proficient in Microsoft Office Suite, PDF Professional, G Suite, or similar software. • A combination of education and experience in a TPA or brokerage environment will be considered • State adjuster’s licenses as required

Benefits

• Competitive compensation • 401(k) plus matching • Health benefits (including HSA Contribution) • Paid disability • Paid parental leave • Professional development opportunities • Hybrid/remote work environment