Workers’ Compensation Claims Representative

3 weeks ago

Fresno CA, United States Insurance Relief Full time

Workers’ Compensation Claims Representative - Hybrid Remote- Fresno, CA
Join a well-established insurance agency with a 30-year legacy and a powerful commitment to ethical, honest insurance solutions. They are actively seeking an experienced Workers' Compensation Claims Representative You will drive success by investigating and evaluating claims, expediting payments, and ensuring proper documentation. Comprehensive benefits package including Medical, Dental, and Vision insurance
~Generous Paid Time Off (PTO) and paid company holidays


3-5+ years of experience in workers' compensation claims
~ Certifications as a Workers Compensation Claims Administrative (WCCA) and Workers Compensation Claims Professional (WCCP) are preferred but not required
~ Knowledge of Worker’s Compensation guidelines, Medicare coding, and compliance obligations.
~ Microsoft Office and other database management systems


Assisting with new claims from opening until satisfactory completion, evidence, and fact-gathering surrounding claims
Ensuring claims coding is true and accurate
Claim files must be accurately recorded in the system
Assuring all claims have a workable plan of action
Reviewing billing summaries
Identifying any signs of fraud and making proper referrals for further investigation
Pursue subrogation when necessary and offer superior customer service to all parties involved

With vast experience in the insurance arena, Insurance Relief™ works with brokers, carriers, and third-party administrators to locate and place the best people for positions ranging from entry-level to senior management.

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