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Workers Compensation Claims Adjuster II

2 months ago

Glendale, California, United States Intercare Holdings Insurance Services, Inc. Full time
{"Job Title": "Workers Compensation Claims Adjuster II", "Job Summary": "We are seeking a highly skilled Workers Compensation Claims Adjuster II to join our team at Intercare Holdings Insurance Services, Inc.", "Responsibilities": "
  • Perform a thorough investigation of all new losses within 24 hours of receipt of the claim to document relevant facts surrounding the incident, disability, and treatment status.
  • Gather and analyze evidence to establish compensability, disability payments, and medical expenses.
  • Develop and implement a plan of action to resolve claims efficiently and effectively.
  • Collaborate with medical case managers to maximize early return to work potential and reduce disability payments.
  • Identify and refer cases with suspected fraud to the Special Investigations Unit.
  • Pursue subrogation from culpable third parties and contributions on multiple defendant cases.
  • Ensure compliance with applicable statutes, service contracts, and company guidelines.
  • Review and approve vocational rehabilitation plans.
  • Establish and adjust monetary case reserves as needed.
  • Review medical bills for appropriateness prior to payment and posting to the claim file.
  • Exhibit a courteous and professional attitude and image on behalf of the company.
  • Respond to inquiries and messages within 24 hours of receipt.
", "Requirements": "
  • Problem Solving: Identifies and resolves problems in a timely manner.
  • Customer Service: Manages difficult customer situations and responds promptly to requests.
  • Interpersonal: Focuses on solving conflict and maintains confidentiality.
  • Team Work: Supports everyone's efforts to succeed.
", "Qualifications": "
  • Bachelor's degree or equivalent from a four-year college or 3-5 years of related experience and training.
  • 5 years of experience without a SIP certificate or equivalent combination of education and experience.
", "Company Overview": "Intercare Holdings Insurance Services, Inc. is a leading provider of workers compensation insurance services. We are committed to delivering exceptional service and support to our clients and customers.", "Contact Information": "For more information, please contact us at [insert contact information]."}