Workers Compensation Claims Examiner
4 days ago
Apidel Technologies is seeking a skilled Workers Compensation Claims Examiner to join our team. As a key member of our claims team, you will be responsible for analyzing and processing complex workers' compensation claims, ensuring timely and cost-effective resolution.
Key Responsibilities- Analyze and process complex workers' compensation claims, investigating and gathering information to determine exposure and manage claims through well-developed action plans.
- Negotiate settlements within designated authority and calculate and assign timely and appropriate reserves to claims.
- Calculate and pay benefits due, approve and make timely claim payments and adjustments, and settle claims within designated authority level.
- Prepare necessary state filings within statutory limits and manage the litigation process, ensuring timely and cost-effective claims resolution.
- Coordinate vendor referrals for additional investigation and/or litigation management, and use appropriate cost containment techniques to reduce overall cost of claims for our clients.
- Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets, and report claims to the excess carrier.
- Communicate claim activity and processing with the claimant and the client, maintaining professional client relationships, and ensure claim files are properly documented and claims coding is correct.
Minimum 3 years of relevant CA WC claims experience is mandatory. California WC Claims handling experience is required. Primary purpose is to analyze complex or technically difficult workers' compensation claims to determine benefits due, work with high exposure claims involving litigation and rehabilitation, ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements, and identify subrogation of claims and negotiate settlements.
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Workers Compensation Defense Attorney
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Insurance Claims Specialist
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Locum Physician for General Medicine Exams
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Student Assistant for Claims Processing
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Social Worker II
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HR Generalist
1 month ago
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Social Worker II
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National City, California, United States Prime Healthcare Full timeAbout the RoleWe are seeking a highly skilled and compassionate Social Worker II to join our team at Paradise Valley Hospital, a member of Prime Healthcare. As a Social Worker II, you will play a vital role in providing emotional support, crisis intervention, and counseling to patients and their families.Key ResponsibilitiesProvide emotional support and...
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Hearing Representative
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Employee Health Nurse
1 day ago
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Assistant Vice President of Risk Management
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Employee Health Nurse
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National City, California, United States Prime Healthcare Full timeJob SummaryThe Employee Health Nurse plays a vital role in maintaining a healthy and safe work environment for our employees. This position is responsible for coordinating employee annual physical examinations, new hire physical clearances, and worker's compensation issues as requested by Human Resources.Key ResponsibilitiesCoordinates employee annual...
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Clinical Social Worker
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Human Resources Coordinator
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Oncology Physician Assistant Position
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HR Generalist
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