Workers Compensation Claims Adjuster III

4 weeks ago


Fresno, United States Intercare Holdings Insurance Services Full time
  • Form a partnership with the medical case manager to maximize early return to work potential thereby reducing the need for extended disability payments, vocational rehabilitation, and other protracted claims costs.
  • Initiate the referral to the SIU of cases with suspected fraud.
  • Aggressively pursue subrogation from culpable third parties, contributions on multiple defendant cases, and apportionment when there is pre-existing disability.
  • Review and approve all vocational rehabilitation plans.
  • Review all medical bills for appropriateness prior to referral to InterMed for payment and posting to the claim file.
  • Requires a working knowledge of the Labor Code of the State of California as it pertains to workers compensation claims and the legal requirements for handling them.
  • Litigation management - Direct, manage, and control the litigation process.
  • Requires a high degree of claims handling expertise to include a minimum of at least five years experience managing indemnity cases, many with complex or high potential subrogation, rehabilitation, medical management, and/or legal issues & possess an SIP certificate.


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