Current jobs related to Workers Compensation Claims Manager - Roseville - PMA Companies


  • Roseville, United States TheBest Claims Solutions Full time $45 - $50

    Our client, is in need of a Temporary Workers' Compensation Claims Adjuster to work in their Roseville, CA office. The ideal candidate will have 2+ years of California Workers Compensation Experience.The experience expected from applicants, as well as additional skills and qualifications needed for this job are listed below.Required Qualifications:2+ years...

  • Claims Manager

    1 week ago


    Roseville, California, United States Pacific ExecSearch Full time

    Job SummaryWe are seeking an experienced Claims Manager to oversee Workers' Compensation claims for an industrial company in the Roseville area. The ideal candidate will have a strong background in claims administration, strategy, and negotiation, with excellent communication and analytical skills.Key ResponsibilitiesManage and oversee all workers'...


  • Roseville, United States TheBest Claims Solutions Full time

    Our client, is in need of a Temporary Workers' Compensation Claims Adjuster to work in their Roseville, CA office. The ideal candidate will have 2+ years of California Workers Compensation Experience.Required Qualifications:2+ years of experience handling CA Workers Compensation claims from inception to close.Ability to manage multiple tasks efficiently...


  • Roseville, California, United States Sedgwick Full time

    Claims Manager Workers CompensationAt Sedgwick, we prioritize taking care of our colleagues and clients. As a Claims Manager Workers Compensation, you will be responsible for managing the technical and operational functions within a dedicated client, ensuring consistent delivery of quality services, managing staffing and training needs, and overseeing budget...


  • Roseville, California, United States Adecco US, Inc. Full time

    Job Title: Workers Compensation Claims ExaminerAdecco US, Inc. is assisting one of their top clients with their search to fill a remote Workers Compensation Claims Examiner role in California.Job Summary:Analyze and process complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on...


  • Roseville, United States Techlink Systems Inc Full time

    Job Title: Claims Examiner - Workers Compensation Location (On-site, Remote, or Hybrid?): Roseville, CA (remote) Contract Duration: Contract until 12/28/2024 REQUIREMENTS: Any license/ certification: CA licensed Years of experience: 4 or more years of relevant WC claims handling experience PRIMARY PURPOSE: To analyze complex or...


  • Roseville, United States Techlink Systems Inc Full time

    Job Title: Claims Examiner - Workers Compensation Location (On-site, Remote, or Hybrid?): Roseville, CA (remote) Contract Duration: Contract until 12/28/2024 REQUIREMENTS: Any license/ certification: CA licensed Years of experience: 4 or more years of relevant WC claims handling experience PRIMARY PURPOSE: To analyze complex or...

  • Claims Examiner

    3 weeks ago


    Roseville, United States Synectics Inc Full time

    Job DescriptionJob DescriptionDescription:To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and...


  • Roseville, California, United States Sedgwick Full time

    Job SummarySedgwick is seeking a skilled Workers Compensation Claims Examiner to join our team. As a Claims Examiner, you will be responsible for analyzing complex workers' compensation claims to determine benefits due. Your expertise will be essential in managing claims through well-developed action plans to achieve timely and cost-effective resolutions.Key...

  • Claims Team Lead

    2 months ago


    Roseville, United States Sedgwick Full time

    About This RoleSedgwick is seeking a highly skilled and experienced Claims Team Lead to join our Workers Compensation team. As a Claims Team Lead, you will be responsible for supervising a team of examiners and technical staff, providing technical direction, and ensuring the efficient and effective management of claims.Key ResponsibilitiesSupervise and...


  • Roseville, California, United States Sedgwick Full time

    Job SummaryWe are seeking a highly skilled Workers Compensation Claims Examiner to join our team at Sedgwick. As a key member of our claims team, you will be responsible for analyzing and processing complex workers' compensation claims, ensuring timely and accurate resolution of claims, and providing exceptional customer service to our clients.Key...


  • Roseville, United States Sedgwick Full time

    About This RoleSedgwick is seeking a highly skilled and experienced Claims Team Lead to join our Workers Compensation team. As a Claims Team Lead, you will be responsible for supervising a team of examiners and technical staff, providing technical direction, and ensuring the efficient and effective management of claims.Key ResponsibilitiesSupervise and...


  • Roseville, United States Robert Half Full time

    Job DescriptionJob DescriptionWe are looking for a detail-oriented Operations Specialist to join our team in Roseville, California. As an Operations Specialist, you will be responsible for managing a large volume of documents, including medical records and legal documentation related to workers compensation claims, and ensuring the efficient operation of the...


  • Roseville, United States Robert Half Full time

    Job DescriptionJob DescriptionWe are in search of a Workers’ Compensation Indemnity Examiner to join our team in the industry of workers' compensation claims based in Roseville, California. This role offers a long-term contract employment opportunity where you will be tasked with preparing for PAR audits, verifying Medicare coding, and handling low...


  • Roseville, United States Sedgwick Full time

    About the RoleSedgwick is seeking a highly skilled and experienced Workers Compensation Claims Team Lead to join our team. As a key member of our leadership team, you will be responsible for supervising multiple teams of examiners and technical staff, providing technical and jurisdictional direction, and ensuring the highest level of quality and service to...


  • Roseville, United States Sedgwick Full time

    About the RoleSedgwick is seeking a highly skilled and experienced Claims Team Lead to join our Workers Compensation Claims Team. As a key member of our team, you will be responsible for supervising multiple teams of examiners and technical staff, providing technical direction, and ensuring the highest level of customer service.Key ResponsibilitiesSupervise...

  • Claims Specialist

    4 days ago


    Roseville, California, United States CorVel Enterprise Comp, Inc. Full time

    Job SummaryWe are seeking a highly skilled Claims Specialist to join our team at CorVel Enterprise Comp, Inc. The ideal candidate will have a strong background in workers' compensation claims management and excellent communication skills.Key Responsibilities:Manage workers' compensation claims from inception to closure, ensuring timely and accurate...

  • Claims Specialist

    1 month ago


    Roseville, California, United States CorVel Enterprise Comp, Inc. Full time

    Job Title: Claims SpecialistCorVel Enterprise Comp, Inc. is seeking a skilled Claims Specialist to join our team. As a Claims Specialist, you will be responsible for managing workers' compensation claims within delegated authority to achieve the best possible outcome.Key Responsibilities:Receive and process claims, confirming policy coverage and...


  • Roseville, United States Sedgwick Full time

    Taking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...


  • Roseville, United States CorVel Corporation Full time

    Job SummaryThe Claims Specialist manages workers' compensation claims within company best practices, ensuring a best possible outcome under the direct supervision of a senior claims professional. This role supports the goals of the claims department and CorVel Corporation.Key ResponsibilitiesReceives claims, confirms policy coverage, and acknowledges the...

Workers Compensation Claims Manager

2 months ago


Roseville, United States PMA Companies Full time
Workers Compensation Claims Manager - CA TPA #4281 Multiple Locations Apply for this job now Job Description:

Job Description:

Provides strategic and technical claims leadership for staff. Manages claims staff to ensure appropriate claim outcomes through consistent execution of best claims practices. Directs staff in the achievement of business plan goals and compliance with legal statutes, policy provisions and company guidelines. Supervises the execution of quality assurance programs. Identifies training needs and manages claims training. Ensures delivery of timely, high quality customer service.

Responsibilities:

  • Develops, recommends and implements short and long range objectives consistent with company business goals, guidelines and programs.
  • Ensures quality management of claims in accordance with best practices and company guidelines.
  • Maintains appropriate staffing levels in conjunction with work loads
  • Selects, trains and manages staff. Plans staff responsibilities and manages activities, utilizing staff resources effectively to meet department goals in accordance with approved plans and budgets. Develop staff to respond to department needs as well as assisting the claims staff with career development goals.
  • Plans and develops annual expense budget for areas of direct responsibility. *Manages adherence to budget.
  • Identifies training needs for staff. Establishes and implements strategy to deliver and or coordinate the delivery of training.
  • Establishes documents and communicates claims settlement and reserving authorities for claims professionals. Grants reserve and settlement authority on cases exceeding supervisor's authority levels.
  • Responsible for ensuring execution of CIR program, inclusive of identification of strengths and deficiencies and implementation of action plan focused on improved results.
  • Monitors and analyzes significant legal developments and legislative changes in service territories that may affect claim operations. *Communicates conclusions and recommendations
  • Participates in claim conferences at which strategy, reserves and settlement authority is established on the most complex and or highest value claims. *Responsible for managing execution of action plans.
  • Utilizes performance management and performance review processes effectively, on an ongoing basis, to maximize performance of employees, correct performance problems, provide development opportunities, and promote effective communication with employees.
  • Promotes effective communication among and between work groups, and between management and employees.
  • Collaborates with Underwriting, Risk Control, Product Development, Marketing and other departments.
  • Ensures a superior level of customer service. Manages account management process and resolution of service issues.
  • Participates in defense counsel evaluation process. Makes recommendations for addition/deletion of counsel.
  • Demonstrate commitment to Company's Code of Business Conduct and Ethics, and apply knowledge of compliance policies and procedures, standards and laws applicable to job responsibilities in the performance of work.

#LI-Remote

Requirements:

Requirements:

  • Bachelor's Degree or equivalent experience; 10 or more years of Workers Compensation claims experience in positions of increasing responsibility required
  • CA residency and claims experience required (7 or more years)
  • 2 years Claims Management experience
  • Extensive knowledge of claims regulations and applicable law is required
  • Prior experience handling/managing claims for self-insured entities will be needed
  • Extensive knowledge of self-insured programs, adjusting techniques and medical terminology
  • Previous experience in a leadership position with proven record of successful team building, goal achievement and superior customer service is required
  • The ability to effectively lead supervisory level staff will be needed
  • Excellent verbal and written communication skills
  • Professional designations desired (CPCU, ARM, AIC, etc.)

Compensation:

PMA is providing applicants with the anticipated wage range for this position in compliance with state regulations. The wage range for this role is $121,400 to $141,600. Wage ranges are based on national market data and may cover a wide range of geographies. Applicants may be paid above, within or below this range based on a variety of factors.

Locations Anaheim Fresno Irvine Long Beach Oakland Roseville San Diego San Francisco San Jose Los Angeles