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Claims Examiner
3 months ago
- $47.85hr
- 5 Month contract with opportunity for extension
- Must Have Requirements:
- Must Reside in CA. Can be hybrid or remote
- 6 years plus Experience
- College degree
- 6+ yrs workers' compensation claims experience.
- SIP certificate from CA
PRIMARY PURPOSE:
Analyze mid- and higher-level workers' compensation claims to determine benefits due, ensure ongoing adjudication within company standards and industry best practices, and identify subrogation opportunities while negotiating settlements.
ESSENTIAL FUNCTIONS and RESPONSIBILITIES:
- Manage workers' compensation claims, determining compensability and benefits due on long-term indemnity claims, monitoring reserve accuracy, and filing necessary documentation with state agencies.
- Develop and manage action plans for workers' compensation claims to resolution, coordinate return-to-work efforts, and approve claim payments.
- Approve and process assigned claims, determining benefits due, and manage action plans pursuant to the claim or client contract.
- Handle subrogation of claims and negotiate settlements.
- Communicate claim actions with claimants and clients.
- Ensure proper documentation of claim files and correct claims coding.
- Process complex lifetime medical and/or defined period medical claims, including state and physician filings, and make decisions on appropriate treatments recommended by utilization review.
- Maintain professional client relationships.
ADDITIONAL FUNCTIONS and RESPONSIBILITIES:
- Perform other duties as assigned.
- Support the organization's quality program(s).
- Travel as required.
If this is a role that interests you and you'd like to learn more, click apply now and a recruiter will be in touch with you to discuss this great opportunity. We look forward to speaking with you
About ManpowerGroup, Parent Company of:Manpower, Experis, Talent Solutions, and Jefferson Wells
ManpowerGroup® (NYSE: MAN), the leading global workforce solutions company, helps organizations transform in a fast-changing world of work by sourcing, assessing, developing, and managing the talent that enables them to win. We develop innovative solutions for hundreds of thousands of organizations every year, providing them with skilled talent while finding meaningful, sustainable employment for millions of people across a wide range of industries and skills. Our expert family of brands - Manpower, Experis, Talent Solutions, and Jefferson Wells - creates substantial value for candidates and clients across more than 75 countries and territories and has done so for over 70 years. We are recognized consistently for our diversity - as a best place to work for Women, Inclusion, Equality and Disability and in 2022 ManpowerGroup was named one of the World's Most Ethical Companies for the 13th year - all confirming our position as the brand of choice for in-demand talent.
