Complex Workers' Compensation Claims Resolution Specialist

3 weeks ago


Rosemead, California, United States Southern California Edison Full time

At Southern California Edison, we are committed to advocating for our injured employees and helping them recover from workplace injuries. As a self-insured and self-administered employer, we focus on supporting our employees through their recovery process so they can return to work safely and enjoy their lives outside of work.

About the Role

We are seeking an experienced Complex Workers' Compensation Claims Resolution Specialist to join our team. This role will be responsible for managing a complex workers' compensation claim caseload, including catastrophic claims as assigned.

The ideal candidate will have seven or more years of experience processing workers' compensation claims, evaluating accident reports to determine accuracy and compliance with laws and regulations. They will also have a thorough knowledge of workers' compensation laws, regulations, disability rates, notices for benefits, and the ability to calculate benefits, awards, commutations, and penalties.

Responsibilities
  • Manage a complex workers' compensation claim caseload, including catastrophic claims as assigned
  • Conduct initial/formal investigations with organizational unit management, medical providers, injured workers, and witnesses on complex claims to determine liability
  • Administer benefits, contain medical costs, and ensure injured employees have immediate access to quality care while coordinating utilization review to ensure medical treatment is appropriate
  • Evaluate claims for resolution and negotiate settlements with injured employees or their representatives within the settlement authority
  • Establish reserves based on the ultimate probable cost of the claim and in accordance with the state of California Self Insurance Plans regulations
Requirements
  • Seven or more years of experience processing workers' compensation claims
  • Thorough knowledge of workers' compensation laws, regulations, disability rates, notices for benefits, and the ability to calculate benefits, awards, commutations, and penalties
  • Demonstrated proficiency in a variety of Claims Management computer programs and systems
Compensation

The estimated salary for this role is between $110,000 - $140,000 per year, depending on experience and qualifications. This position's work mode is hybrid, with the employee reporting to an SCE facility for a set number of days and working remotely on the remaining days.

About Us

Southern California Edison is a leader in the energy industry, powering the clean energy revolution and creating a better tomorrow. We are committed to ensuring that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.



  • Rosemead, California, United States Katie W Chu OD INC Full time

    Job OverviewKatie W Chu OD INC is seeking an Optometric Office Support Specialist to join our team. This role is responsible for providing exceptional support in a fast-paced front and back office environment.Key ResponsibilitiesAnswering phone calls and responding to patient inquiriesBooking appointments and managing schedulesVerifying insurance coverages...


  • Rosemead, California, United States American Water Full time

    Overview: At American Water, we are committed to delivering safe and reliable water and wastewater services to our customers. We seek a highly skilled Water Resources Planning Specialist to join our team in Sacramento, Monterey, or Rosemead, California.">Job Summary: The Water Resources Planning Specialist will be responsible for conducting strategic...


  • Rosemead, California, United States Match Point Solutions Full time

    At MatchPoint Solutions, we are a fast-growing global IT-Engineering services company providing technology solutions to clients across the US and internationally. Our innovative culture inspires business results from idea to outcome, keeping our clients at the forefront of latest technologies.We are excited to expand our team and are seeking an experienced...


  • Rosemead, California, United States The Judge Group Full time

    About The RoleThe Judge Group is seeking a highly skilled Strategic Operations Excellence Lead to join our team. This is an exciting opportunity for a seasoned professional to drive operational excellence and lead strategic initiatives.Key ResponsibilitiesThe Strategic Operations Excellence Lead will be responsible for managing a small team focused on...


  • Rosemead, California, United States Redwood Full time

    About the Opportunity:">Redwood Family Care Network is an innovative leader in delivering person-centered home and community-based services to individuals with intellectual and developmental disabilities.">Job Overview:">We are seeking a compassionate Caregiver and Support Specialist to join our team in Santa Fe Springs, CA.">Responsibilities:">Main...

  • Cost Engineer Manager

    3 weeks ago


    Rosemead, California, United States PM2CM Inc Full time

    Overview">The ideal candidate for this position will have a strong background in project finance and cost management, with experience in developing and managing budgets, forecasts, and expenditure plans.Job SummaryWe are seeking a highly skilled Cost Engineer Manager to join our team at PM2CM Inc. in Rosemead, CA. The successful candidate will be responsible...


  • Rosemead, California, United States Southern California Edison Full time

    **Transforming Business Operations with Excellence**At Southern California Edison, we're driving the clean energy revolution and seeking a highly skilled Strategic Process Enhancement Specialist. In this pivotal role, you'll collaborate with cross-functional teams to evaluate and improve operational processes, ensuring seamless execution of key business...

  • UiPath Expert

    3 hours ago


    Rosemead, California, United States Diverse Lynx Full time

    Technical RequirementsWe are seeking a skilled professional with extensive experience in Automation Solutions Development. The ideal candidate will have a strong background in RPA, UiPath, and Agile methodology.Responsibilities:Design and develop RPA solutionsLeverage UiPath's advanced features to automate business processesCollaborate with stakeholders to...


  • Rosemead, California, United States MedCentric, Inc. Full time

    About MedCentric, Inc. We are seeking a compassionate and experienced Primary Care Physician to join our interdisciplinary team in Stockton, California.Job SummaryThis role emphasizes relationship-building and quality care, particularly in a value-based environment. The ideal candidate will have experience working with frail, elderly patients, with a strong...

  • Therapy Specialist

    3 weeks ago


    Rosemead, California, United States Soliant Full time

    Job OverviewWe are seeking a dedicated Occupational Therapist to provide services for school age students in grades K-12.Key Responsibilities:Provide occupational therapy services to meet the needs of students.Collaborate with teachers and staff to develop and implement effective plans.Conduct assessments and evaluations to identify student strengths and...


  • Rosemead, California, United States LeadStack Inc. Full time

    Job SummaryWe are seeking a highly skilled and experienced Administrative Aide 3 to join our team at LeadStack Inc. As an award-winning, one of the nation's fastest-growing, certified minority-owned staffing services provider, we offer a dynamic work environment with opportunities for growth and development.Key ResponsibilitiesBroad knowledge of department...


  • Rosemead, California, United States American Water Full time

    **About American Water**We are committed to keeping life flowing by providing essential services to our customers. As a leading utility company, we strive to deliver safe, clean, reliable, and affordable drinking water and wastewater services. Our dedicated team of professionals leverages their expertise and national size and scale to achieve excellent...


  • Rosemead, California, United States Red Seal Recruiting Solutions Ltd. Full time

    Unlock New Opportunities as a Business Development Director for Healthcare SalesWe are currently seeking a highly motivated and experienced Business Development Director for Healthcare Sales to join our team at Red Seal Recruiting Solutions Ltd.This is an exciting opportunity for a results-driven professional with a proven track record of success in sales...


  • Rosemead, United States Target Full time

    Target - 3600 Rosemead Blvd [Asset Protection / Loss Prevention] As a Security Specialist at Target, you'll: Contribute to a team in the development of a secure work environment for all Target team members, temporary workers, vendors and visitors; Execute routines to identify and investigate theft; Help advance Assets Protection partnerships through...


  • Rosemead, United States Target Full time

    Target - 3600 Rosemead Blvd [Loss Prevention / Security] As a Security Specialist at Target, you'll: Contribute to a team in the development of a secure work environment for all Target team members, temporary workers, vendors and visitors; Execute routines to identify and investigate theft; Help advance Assets Protection partnerships through professional...

  • Project Specialist 4

    3 weeks ago


    Rosemead, United States The Judge Group Full time

    Our client is currently seeking a Project Specialist 4 Description:Responsible for user liaison, system specifications, systems design, analysis, and project control. May also interact with Analysts and Programmers through implementation phases and occasionally assist in programming effort. Provide key link between ultimate user and computing resource....

  • Program Specialist

    3 weeks ago


    Rosemead, United States Universal Health Services, Inc. Full time

    Responsibilities BHC Alhambra Hospital Program Specialist I (PSI)- Per Diem Available Shifts:PM SHIFT: 3:00 PM-11:30 PMNOC SHIFT: 11:00 PM-7:30 PM Are you caring, compassionate and hardworking?Apply today to join our amazing team! BHC Alhambra Hospital is located in the beautiful city of Rosemead,...


  • Rosemead, United States The Judge Group Full time

    Our client is currently seeking a Continuous Improvement Consultant In line with the companys long term strategic goal of integrating Operational and Service Excellence (OpX) into our culture and business model through a systematic deployment of continuous improvement practices across the organization Strategy, Integrated Planning & Performance organization...


  • Rosemead, United States eTeam Full time

    Job Title: Continuous Improvement ConsultantLocation: Rosemead, CAPay Rate: $40 to $45/hr on W2Duration: 12+ MonthsJob Description:In line with the company’s long-term strategic goal of integrating Operational and Service Excellence (OpX) into our culture and business model through a systematic deployment of continuous improvement practices across the...


  • Rosemead, United States Vertisystem Full time

    Notes:Job Title: Continuous Improvement Consultant (SCE2JP00002802)Location: Rosemead, CA, 91770Employment Type: W2Duration: 18+ Months with potential for extensionDescription:• In line with the company’s long term strategic goal of integrating Operational and Service Excellence (OpX) into our culture and business model through a systematic deployment of...


  • Rosemead, United States Russell Tobin Full time

    Russell Tobin + Associates is currently seeking a Continuous Improvement Project Manager. This is a 18+ months contract with potential for extension/conversion for successful contractors!Position: Continuous Improvement Project Manager Location: Rosemead, CA 91770Contract: 18+ months with possible extensionPay Range: $43.00-45.00/hr depending on...


  • Rosemead, United States Russell Tobin Full time

    Russell Tobin + Associates is currently seeking a Continuous Improvement Project Manager. This is a 18+ months contract with potential for extension/conversion for successful contractors!Position: Continuous Improvement Project Manager Location: Rosemead, CA 91770Contract: 18+ months with possible extensionPay Range: $43.00-45.00/hr depending on...


  • Rosemead, United States Aptara Full time

    Continuous Improvement ManagerStart: ImmediateDuration: Through June 2026Location: ONSITE Rosemead, CA$46.50 Per Hour + All Benefits – health, life, 401K etc.ResponsibilitiesThe Continuous Improvement Manager/ Master Black belt will manage a small team that will be focused on benchmarking and replication of best practices as well as data analytics, looking...


  • Rosemead, United States Aptara Full time

    Continuous Improvement ManagerStart: ImmediateDuration: Through June 2026Location: ONSITE Rosemead, CA$46.50 Per Hour + All Benefits – health, life, 401K etc.ResponsibilitiesThe Continuous Improvement Manager/ Master Black belt will manage a small team that will be focused on benchmarking and replication of best practices as well as data analytics, looking...


  • Rosemead, United States APR Consulting Full time

    An electric utility client is looking for a Continuous Improvement Manager who will manage a small team that will be focused on benchmarking and replication of best practices as well as data analytics, looking for improvement opportunities across the organization.Location: Rosemead, CA 91770Position: Continuous Improvement ManagerPay Rate: $46.43/hr. on...

  • Master Black Belt

    4 weeks ago


    Rosemead, United States APR Consulting Full time

    An electric utility client is looking for a Master Black Belt who will manage a small team that will be focused on benchmarking and replication of best practices as well as data analytics, looking for improvement opportunities across the organization.Location: Rosemead, CA 91770Position: Master Black BeltPay Rate: $46.43/hr. on W2Duration: 18 months or...


  • Rosemead, United States APR Consulting Full time

    An electric utility client is looking for a Process Improvement Lead who will manage a small team that will be focused on benchmarking and replication of best practices as well as data analytics, looking for improvement opportunities across the organization.Location: Rosemead, CA 91770Position: Process Improvement LeadPay Rate: $46.43/hr. on W2Duration: 18...

  • Master Black Belt

    4 weeks ago


    Rosemead, United States APR Consulting Full time

    An electric utility client is looking for a Master Black Belt who will manage a small team that will be focused on benchmarking and replication of best practices as well as data analytics, looking for improvement opportunities across the organization.Location: Rosemead, CA 91770Position: Master Black BeltPay Rate: $46.43/hr. on W2Duration: 18 months or...


  • Rosemead, United States APR Consulting Full time

    An electric utility client is looking for a Continuous Improvement Manager who will manage a small team that will be focused on benchmarking and replication of best practices as well as data analytics, looking for improvement opportunities across the organization.Location: Rosemead, CA 91770Position: Continuous Improvement ManagerPay Rate: $46.43/hr. on...


  • rosemead, United States AMETEK Full time

    As an EHS Manager, you will accountable to lead and manage all Environmental, Health and Safety (EHS) programs and systems for the sites in Rosemead, CA (Hermetic Seal) and Cincinnati, OH (Sealtron). Maintain compliance with regulations USEPA, OSHA, state, and local agencies.  Daily responsibility for the continuous improvement of all Company EHS...


  • Rosemead, United States First Tek Full time

    Monitoring Daily Operations: Ensuring that all operational processes are running smoothly and efficiently. Process Improvement: Identifying areas for improvement and implementing strategies to enhance process efficiency. Collaboration: Working with other departments to develop business process models and performance metrics. Documentation: Preparing detailed...

  • SLPA Rosemead, CA

    3 months ago


    Rosemead, United States Soliant Full time

    Job DescriptionJob DescriptionMinimum 1+ years speech therapy experience required.Soliant Health is currently seeking a dedicated and passionate Speech-Language Pathologist Assistant (SLPA) to join our team near Rosemead. This is a fantastic opportunity to make a positive impact on the lives of individuals in need of speech-language services. If you are...

  • Wire Specialist

    7 months ago


    Rosemead, United States Cathay Bank Full time

    GENERAL SUMMARY Under supervision and following established policies and department procedures operate various fund transfers and communication computer systems as described in Essential Functions. ESSENTIAL FUNCTIONS Operate Payplus wire application and process funds transfers (incoming and outgoing). Operate SWIFT system and process various...