Job Description

Job Description

Job Description

We are looking for  Claims Adjuster - Workers Compensation for our client in  Sacramento, CA

Job Title: Claims Adjuster - Workers Compensation

Job Location: Sacramento, CA

Job Type: Contract

Job Description:

Pay Range: $47hr - $52hr

Responsibilities:

• Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
• Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments. 
• Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract. 
• Manages subrogation of claims and negotiates settlements. 
• Communicates claim action with claimant and client.
• Ensures 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.
• Maintains professional client relationships. 

Education and Licensing:

• Bachelor's degree from an accredited college or university preferred. 

Experience:

• Four years of claims management experience or equivalent combination of education and experience required. 

Skills and Knowledge:

• 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. 
• Analytical and interpretive skills Strong organizational skill.
• Good interpersonal skills Excellent negotiation skills. 
• Ability to work in a team environment Ability to meet or exceed Service Expectations.

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