Claims Examiner - Workers Compensation
Job details
Claims Examiner - Workers Compensation BCforward is looking for Workers' Compensation Claims Analyst (Remote) Position Title: Workers' Compensation Claims Analyst Location: Remote in California Anticipated Start Date: ASAP Expected Duration: 03+ Months Contract to Hire Job Type: Full Time/ W2 Pay Rate: $45 per hour on W2 Summary:
- We are seeking a highly experienced Workers' Compensation Claims Analyst to join our team. The ideal candidate will have at least 3 years of experience in claims management, preferably with expertise in JURIS. This position involves analyzing complex claims, negotiating settlements, and ensuring compliance with industry regulations. The role offers flexible scheduling and may consider remote work arrangements.
- Analyze complex workers' compensation claims to determine benefits due.
- Manage claims through well-developed action plans to achieve timely resolutions.
- Negotiate settlements within designated authority.
- Calculate and assign appropriate reserves to claims.
- Prepare necessary state filings within statutory limits.
- Manage the litigation process and ensure cost-effective claims resolution.
- Coordinate vendor referrals for additional investigation or litigation management.
- Utilize cost containment techniques to reduce overall claims costs.
- Manage claim recoveries, including subrogation and offsets.
- Communicate claim activity and processing with claimants and clients.
- Ensure claim files are properly documented and coded.
- Refer cases as appropriate to supervisor and management.
- Bachelor's degree preferred.
- Professional certification in relevant field preferred.
- Five years of claims management experience or equivalent combination of education and experience required.
- Expert knowledge of insurance principles and laws, claim and disability duration, and cost containment practices.
- Excellent communication, analytical, and negotiation skills.
- Proficiency in Microsoft Office products.
- Strong organizational and interpersonal skills.
- Ability to work independently and in a team environment.
- Ability to meet or exceed service expectations.
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