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Workers Compensation Claims Adjuster
2 months ago
Job Summary:
Amtec Enterprise is seeking a highly skilled Workers Compensation Claims Adjuster to join our team. As a Workers Compensation Claims Adjuster, you will be responsible for processing a wide variety of worker's compensation claims, including complex or sensitive cases.
Key Responsibilities:
- Claims Processing: Receive and review Workers Compensation claims and reports, determining if occupational illness or injury is compensable, and authorizing and computing payment utilizing California State Workers Compensation Law.
- Documentation and Communication: Develop documentation for claim reports, requesting substantiating reports from physicians, supervisors, and witnesses, and reviewing injury reports for completeness and consistency.
- Benefits Administration: Explain to injured workers their benefits and legal rights under Workers Compensation Laws, and prepare subrogation and litigation cases, corresponding with doctors and attorneys on litigated cases.
- Record Keeping and Reporting: Maintain accurate records, produce records, and attest to validity under the direction of the court by subpoena, and prepare briefs of Personnel and Health Department information to Workers Compensation attorneys for submittal to the Workers Compensation Appeals Board.
- Training and Development: Provide informational seminars or in-service training to explain the County Workers Compensation Program, and may assign and review the work of others, train new employees, and provide vacation and temporary relief as required.
Requirements:
- Experience: Four to five years of experience, within the last five years, adjusting workers compensation claims, including one year adjusting complex litigated claims, such as continuous trauma, AOE/COE, stress claims, and safety claims.
- Skills: Ability to review Workers Compensation claims, and reports, and determine if occupational illness or injury is compensable, authorize and compute benefit payment, and ability to explain to injured workers their benefits and legal rights under Workers Compensation Laws.
- Education: Bachelor's degree in a related field, such as Risk Management, Business Administration, or a related field.
Working Conditions:
This is a full-time position, and the selected candidate will be subject to a background check upon selection.
