Workers Compensation Claims Adjuster III

4 weeks ago


Fresno, California, 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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