Adecco is seeking an experienced Workers' Compensation Claims Examiner to manage complex and technically difficult workers' compensation claims. This role involves evaluating claims, managing litigation and rehabilitation efforts, ensuring claims are adjudicated according to service expectations and industry best practices, and negotiating settlements. The ideal candidate will have a strong background in claims management, subrogation, and working with high exposure cases.
Location: Remote (California)
Job Type: Temporary (Full-Time)
Work Hours: 8:00 AM - 4:30 PM
Pay Rate: $50.00 per hour
Essential Functions and Responsibilities:
Claims Analysis & Management: Analyze and process complex workers' compensation claims by investigating and gathering information to assess exposure. Develop and implement action plans for timely and appropriate resolution of claims.
Settlement Negotiation: Negotiate the settlement of claims within designated authority limits and manage reserves throughout the life of the claim.
Claims Payments: Calculate, approve, and process benefit payments and adjustments in accordance with established timelines.
Litigation Management: Oversee the litigation process, ensuring timely and cost-effective resolution of claims. Coordinate with external vendors for additional investigation or litigation management.
Cost Containment: Use appropriate cost containment strategies, including vendor partnerships, to minimize the overall cost of claims.
Subrogation & Recovery Management: Manage claim recoveries, including subrogation, Social Security and Medicare offsets, and Second Injury Fund excess recoveries.
Client Communication: Maintain professional communication with clients and claimants, providing regular updates on claim activity and processing.
Reporting: Report claims to excess carriers and respond to requests in a timely and professional manner.
File Documentation: Ensure claim files are thoroughly documented, with correct coding and compliance with statutory requirements.
Collaboration: Refer cases to management or supervisors as necessary and collaborate with the team to meet service expectations.
Additional Functions and Responsibilities:
Perform other duties as assigned.
Support the organization's quality programs and initiatives.
Travel as required for job-related tasks.
Qualifications:
Bachelor's degree from an accredited college or university preferred.
Professional certification (SIP) as applicable to workers' compensation claims preferred.
A minimum of five (5) years of claims management experience or an equivalent combination of education and experience.
Expertise in workers' compensation claims handling, including knowledge of insurance principles, recovery offsets, disability duration, cost containment, and medical management practices.
Strong analytical and interpretive skills.
Excellent verbal and written communication skills, including the ability to present information effectively.
Proficient in Microsoft Office Suite and other relevant software.
Strong organizational, negotiation, and interpersonal skills.
Ability to work independently as well as in a team environment.
Ability to meet service expectations and deadlines.
Work Environment:
Mental: Clear, conceptual thinking with excellent judgment and problem-solving abilities. Able to handle multiple priorities and work-related stress while meeting deadlines.
Physical: Frequent computer use, keyboarding, and occasional travel may be required.
Auditory/Visual: Must have the ability to hear, see, and speak clearly.
Note: A background credit check and security clearance will be required for this position.
If you are interested in this position, apply today with your up to date resume!
Pay Details: $50.00 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.adecco.com/en-us/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
The California Fair Chance Act
Los Angeles City Fair Chance Ordinance
Los Angeles County Fair Chance Ordinance for Employers
San Francisco Fair Chance Ordinance
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