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Claims Adjuster - Workers Compensation

  • Location: Orange, 92868
  • Job Type:Contract

Posted 6 days ago

Position: Claims Adjuster - Workers Compensation
Location: Orange, CA 92868
Term: 1 month

Day-to-Day Responsibilities:
  • Manage workers compensation claims determining compensability and benefits due on long term indemnity claims, monitor reserve accuracy, and files necessary documentation with state agency.
  • Develop and manage workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approve claim payments.
  • Approve and process assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
  • Manage subrogation of claims and negotiates settlements.
  • Communicate claim action with claimant and client.
  • Ensure claim files are properly documented and claims coding is correct.
  • Process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
  • Maintain professional client relationships.
  • Perform other duties as assigned.
  • Support the organization's quality program(s).
  • Travels as required.
 
Is this a good fit? (Requirements):
  • Bachelor's degree from an accredited college or university.
  • Experience Four (4) years of claims management experience or equivalent combination of education and experience.
  • Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business.
  • Excellent oral and written communication, including presentation skills PC literate, including Microsoft Office products.
  • Reside in California as this is a self-insured client.

Candidates will be responsible for following the client's COVID-19 protocols. Please refer to your MATRIX representative for specifics.

About Us

At MATRIX, we expertly match talented professionals with job opportunities to elevate careers. Since 1983, we have placed thousands of professionals at innovative clients across every industry ranging from small startups to Fortune 50 companies. It’s why we’re consistently in the top 25 of all U.S. IT staffing firms and why our consultants rate us well above the industry average, earning us ClearlyRated's Best of Staffing awards year after year. People come to us for a job, and stay with us because of our top-notch consultant care.

MATRIX is and Equal Employment Opportunity employer and provides reasonable accommodations for qualified individuals.  Supporting medical or religious documentation will be required where applicable. If you are a qualified individual with a disability, you may request a reasonable accommodation under the American Disability Act (ADA) by emailing MATRIX_HR@MatrixRes.com. To ensure a quick response to your request, please use the words “Accommodation request” as the subject line of your email.