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Claims Adjuster I

2 months ago

Glendale, California, United States EMPLOYERS Full time
Job Summary

We are seeking a skilled Claims Adjuster I to join our team at EMPLOYERS, a dynamic and fast-growing provider of workers' compensation insurance and services. As a Claims Adjuster I, you will play a critical role in the timely and accurate management of workers' compensation claims with low to moderate medical and indemnity benefit exposure and minimal litigation.

Key Responsibilities
  • Receive and review new claims involving low to moderate medical, indemnity, and occasional legal exposure.
  • Complete initial contacts to obtain necessary information, verify coverage, determine compensability, and develop a plan of action.
  • Analyze case facts to establish timely reserves using knowledge of medical-related costs and judgment about extent of disability.
  • Provide timely and appropriate customer service within established best practices.
  • Maintain ongoing professional communications with all internal and external customers.
  • Evaluate and pay benefits in compliance with statutory and company guidelines.
  • File appropriate state forms, as needed.
  • Proactively coordinate or monitor medical treatment to continue to move the claim forward.
  • Use resources, internal and external, to contain costs and manage exposure.
  • Work with supervisor to review and analyze some legal issues.
  • In collaboration with defense attorneys, proactively handle and mitigate exposure to litigation and price up claims for minor settlements.
Requirements
  • Excellent communication and customer service skills.
  • Knowledge of an imaged environment.
  • Self-motivated with excellent analytical, problem-solving, and decision-making skills.
  • Strong ability to multi-task and prioritize.
  • High School Diploma or GED equivalent.
  • Preferred but not required: One to two years of related claims, medical, legal, or insurance industry experience.
  • Knowledge of workers' compensation laws, regulations, and statutes preferred.
  • Bachelor's degree or equivalent business experience preferred.
  • WCCP, AIC, ARM, CPCU, or other insurance certification a plus.
What We Offer

We offer a comprehensive benefits package, including a salary range of $40,000 - $58,000, and a positive, challenging work environment. As a remote employee, you will have the flexibility to work from home and enjoy a work-life balance. We are committed to providing our employees with opportunities for growth and development, and we are excited to welcome a skilled Claims Adjuster I to our team.