Current jobs related to Workers Compensation Claims Adjuster - Orange, California - Intercare Insurance Services

  • Workers' Compensation Claims Specialist

    3 weeks ago

    Orange, California, United States Petra Risk Solutions Full time

    Job OverviewWe are seeking a detail-oriented Compensation Specialist to support our clients in managing workers' compensation claims. The ideal candidate will have a strong background in workers' compensation claims and related employment labor law, with the ability to handle sensitive employee information.Key ResponsibilitiesReview, analyze, and monitor...

  • Workers Compensation Claims Specialist

    2 months ago

    Orange, California, United States Intercare Insurance Full time

    Job Description**Job Summary:**As a Workers Compensation Claims Specialist at Intercare Insurance, you will play a critical role in managing and resolving workers' compensation claims in a timely and efficient manner. This position requires a high degree of claims handling expertise, including experience in managing indemnity cases with complex or high...

  • Workers Compensation Claims Handler

    2 weeks ago

    Orange, California, United States Sedgwick Full time

    Job SummaryWe are seeking a skilled Workers Compensation Claims Handler to join our team in California. As a Claims Handler, you will be responsible for analyzing and processing claims to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.Key...

  • Workers Compensation Claims Specialist

    2 weeks ago

    Orange, California, United States Intercare Insurance Full time

    Job DescriptionJob Summary:As a Workers Compensation Claims Specialist at Intercare Insurance, you will be responsible for managing an assigned inventory of claim files, including cases of extreme complexity or with unique issues. You will work closely with the Claims Supervisor and medical case manager to maximize early return to work potential and reduce...

  • Claim Representative

    2 weeks ago

    Orange, California, United States Sedgwick Full time

    About the RoleWe are seeking a highly motivated and detail-oriented Claim Representative to join our team at Sedgwick. As a Claim Representative, you will be responsible for analyzing workers compensation, general liability, or disability claims and determining benefits due. This is an excellent opportunity to develop your skills and knowledge in claims...

  • Claim Representative

    2 weeks ago

    Orange, California, 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 your...

  • Insurance Claims Specialist

    1 week ago

    Orange, California, United States Sedgwick Claims Management Services Full time

    To excel as a skilled industry professional, you will be trained to analyze workers compensation, general liability, or disability claims and determine benefits due. Key responsibilities include:Essential Functions:Attend and complete designated training programs.Develop expertise in workers compensation, general liability, and disability claims.Apply...

  • Claims Resolution Specialist

    2 weeks ago

    Orange, California, United States Sedgwick Claims Management Services Full time

    Job SummaryTo succeed in this role, you will be oriented and trained as a new industry professional with the ability to analyze workers compensation, general liability, or disability claims and determine benefits due.Essential Functions:Attend and complete designated training programs to develop industry knowledge and skills.Analyze claims data to determine...

  • Claims Examiner

    1 month ago

    Orange, California, United States BCforward Full time

    Job Title: Workers Compensation Claims ExaminerBCforward is seeking a highly motivated Workers' Compensation Claims Examiner for an opportunity in Orange, CA.Job Summary:The primary purpose of this role is to analyze complex or technically challenging workers' compensation claims, determine benefits due, and manage high-exposure claims involving litigation...

  • Senior Property Claim Adjuster

    1 week ago

    Orange, California, United States The Travelers Companies, Inc Full time

    Job SummaryWe are seeking a highly skilled Senior Property Claim Adjuster to join our team at The Travelers Companies, Inc. As a key member of our claims department, you will be responsible for handling complex first-party property claims with high severity and complexity.Key ResponsibilitiesInvestigate and evaluate claims to determine coverage, damages, and...

  • Workers' Compensation Defense Attorney

    2 weeks ago

    Orange, California, United States W3Global Inc Full time

    Job OverviewW3Global Inc is seeking an experienced Workers' Compensation Defense Attorney to join our team in Orange County, CA.The ideal candidate will have a strong background in workers' compensation law and be able to handle all aspects of defending workers' compensation claims for benefits, including medical, disability, impairment, increased benefits...

  • Daily Property Field Adjuster

    2 weeks ago

    Orange, California, United States Alacrity Solutions Full time

    Job DescriptionAlacrity Solutions is a leading provider of insurance claims services, delivering streamlined solutions for property, auto, heavy equipment, and casualty claims management. As an independent contractor, you will work as a Daily Property Field Adjuster, providing excellent claim handling services for our clients.Key Responsibilities:Provide...

  • Workers' Compensation Attorney

    2 weeks ago

    Orange, California, United States THE TRAVELERS INDEMNITY COMPANY Full time

    Job OverviewWe are seeking a skilled Workers' Compensation Attorney to join our team at The Travelers Indemnity Company. As a Counsel, you will be responsible for handling a caseload of predominantly low to moderate complexity, providing high-quality, proactive case handling, and delivering optimal results for our insured customers.Key ResponsibilitiesYour...

  • Claims Assistant

    2 weeks ago

    Orange, California, United States Intercare Insurance Full time

    Job Title: Workers Compensation Claims AssistantIntercare Insurance is seeking a highly organized and detail-oriented Workers Compensation Claims Assistant to join our team.The ideal candidate will have excellent communication skills, be able to work independently, and have a strong understanding of workers compensation laws and regulations.Key...

  • Workers' Compensation Attorney

    4 weeks ago

    Orange, California, United States gpac Full time

    Job Title: Workers' Compensation AttorneyWe are seeking an experienced Workers' Compensation Attorney to join our team at GPAC, a highly regarded search firm specializing in placing quality professionals within multiple industries across the United States.Job Summary:The ideal candidate will have 5-15 years of experience in Workers' Compensation law, with a...

  • Workers' Compensation Attorney

    2 weeks ago

    Orange, California, United States gpac Full time

    Job Title: Workers' Compensation AttorneyWe are seeking an experienced Workers' Compensation Attorney to join our team at a highly regarded and well-established law firm with multiple offices throughout California. The ideal candidate will have 5-15 years of experience in Workers' Compensation law and be licensed to practice law in California.Key...

  • Workers' Compensation Defense Attorney

    3 weeks ago

    Orange, California, United States Jobot Full time

    Job DetailsJobot is seeking a 100% remote Workers' Compensation Defense Attorney to join our team.About the RoleWe are a multi-service litigation firm with a strong focus on Workers' Compensation Defense. As a remote Workers' Compensation Defense Attorney, you will be responsible for defending clients in Workers' Compensation cases.RequirementsJD from an...

  • Claims Assistant

    1 week ago

    Orange, California, United States Intercare Insurance Services Full time

    Job Title: Workers Compensation Claims AssistantJob Summary: We are seeking a highly organized and detail-oriented Claims Assistant to join our team at Intercare Insurance Services. The successful candidate will provide clerical operations support to our Claims Specialists, ensuring seamless claims processing and exceptional customer service.Key...

  • Workers' Compensation Defense Attorney

    1 week ago

    Orange, California, United States Jobot Full time

    Job DetailsJobot, a 130M+ multi-service litigation firm, is seeking a 100% remote Workers' Compensation Defense Attorney. This role involves defending clients in workers' compensation cases. The ideal candidate will have a JD from an approved law school, a minimum of 1 year of experience practicing in Workers' Compensation Defense, and an active CA bar...

  • Claims Assistant

    2 weeks ago

    Orange, California, United States Sedgwick Full time

    About the RoleWe are seeking a highly organized and detail-oriented Claims Assistant to join our team at Sedgwick. As a Claims Assistant, you will play a critical role in supporting our claims staff and performing various office tasks.Key ResponsibilitiesSet up and enter new claims into our claims management systemInput and review notes/diaries in the claims...

Workers Compensation Claims Adjuster

2 months ago

Orange, California, United States Intercare Insurance Services Full time
Job Title: Workers Compensation Claims Adjuster

At Intercare Insurance Services, we are seeking a highly skilled and experienced Workers Compensation Claims Adjuster to join our team.

Job Summary:

The Workers Compensation Claims Adjuster will be responsible for effectively managing to conclusion an assigned inventory of claim files that may include cases of extreme complexity or with unique or unusual issues.

Key Responsibilities:
  • Claims Management: Perform a three-point contact on all new losses within 24 hours of receipt of the claim to include the claimant, employer, and treating physician to document relevant facts surrounding the incident itself as well as disability and treatment status.
  • Case Documentation: Thoroughly and accurately document ongoing case facts and relevant information necessary for establishing compensability, the need for disability payments, the use of vendors, medical and expense payments, and what is being done to move the case toward closure.
  • Indemnity Claims: Assure that all assigned indemnity claims have an up to date plan of action outlining activities and actions anticipated for ultimately resolving the claim.
  • Medical Case Management: 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.
  • Fraud Investigation: Initiate the referral to the SIU of cases with suspected fraud.
  • Subrogation: Aggressively pursue subrogation from culpable third parties, contributions on multiple defendant cases, and apportionment when there is pre-existing disability.
  • Compliance: Assure that the claim file is handled totally in accordance with applicable statutes as well as in-force service contracts and company guidelines.
  • Vocational Rehabilitation: Review and approve all vocational rehabilitation plans.
  • Monetary Case Reserves: Establish, monitor, and adjust monetary case reserves when warranted and in strict accordance with assigned authority levels.
  • Medical Bill Review: Review all medical bills for appropriateness prior to referral to InterMed for payment and posting to the claim file.
  • Professional Image: Exhibit and maintain a courteous and helpful attitude and project a professional image on behalf of the company.
  • Communication: Respond to telephone messages and inquiries within 24 hours of receipt and to written inquiries within one week of receipt.
  • Knowledge and Skills: 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.
Requirements:
  • Problem Solving: Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Uses reason even when dealing with emotional topics.
  • Customer Service: Manages difficult or emotional customer situations; Responds promptly to customer needs; Responds to requests for service and assistance; Meets commitments.
  • Interpersonal: Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
  • Team Work: Supports everyone's efforts to succeed.
Qualification Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience:

Bachelor's degree (B. A.) from four-year college or university; at least seven years related experience and/or training; or equivalent combination of education and experience. 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.