Our client is looking for a Claims Adjuster on a 6-months contract. Will be working onsite in Sacramento, CA.
Join over 20,000 employees at this global company specializing in technology-enabled claims and risk management solutions. You will be part of a culture that is constantly recognized for progressive, inclusive employment practices, and be part of a bigger movement to simplify complexities in the areas of workers compensation, liability, property, disability, and absence management.
You will work alongside some of the smartest minds in the industry who are excited to share their knowledge and to learn from you.
Contract Duration: months
Required Skills & Experience
Join over 20,000 employees at this global company specializing in technology-enabled claims and risk management solutions. You will be part of a culture that is constantly recognized for progressive, inclusive employment practices, and be part of a bigger movement to simplify complexities in the areas of workers compensation, liability, property, disability, and absence management.
You will work alongside some of the smartest minds in the industry who are excited to share their knowledge and to learn from you.
Contract Duration: months
Required Skills & Experience
- High School Graduate/GED.
- 4 years of Claims Management 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.
Desired Skills & Experience
- Bachelor's degree.
- SIP Certification
What You Will Be Doing
- Analyze mid- and higher-level workers compensation claims to determine benefits due.
- Ensure ongoing adjudication of claims within company standards and industry best practices.
- Identify subrogation of claims and negotiate settlements.
- Manage workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors 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 approves 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.
- May 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).
- Travel as required.