Sr. Workers' Compensation Claims Adjuster
2 days ago
Must have a California SIP (Workers Compensation - Sr. Work Comp Claims Adjuster)
Temp-to-Hire position
Salary/Pay: Salary is $90,000 - $95,000 with the temporary employment hourly wage range of $43.26 - $45.66/hour
(Hybrid Position requiring two (2) days in the office)
POSITION SUMMARY: Under minimal supervision manages all aspects of indemnity claims handling from inception to conclusion within established authority and guidelines.
DUTIES AND RESPONSIBILITIES:
- Effectively manages a caseload of 150 to 180 workers’ compensation files, including very complex claims.
- Initiates and conducts investigation in a timely manner.
- Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.
- Manages medical treatment and medical billing, authorizing as appropriate.
- Refers cases to outside defense counsel. Directs and manages as appropriate.
- Communicates with claimants, providers and vendors regarding claims issues.
- Computes and set reserves within Company guidelines. Limits are larger than those allowed for Claims Adjuster I and Claims Adjuster II.
- Settles and/or finalize all claims and obtains authority as designated.
- Maintains diary system for case review and documents file to reflect the status and work being performed on the file.
- Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns.
- Adheres to all Company policies and procedures.
- Conducts file reviews independently.
- Other duties as assigned.
* Essential job function.
EQUIPMENT OPERATED/USED: Computer, fax machine, copier, printer, and other office equipment.
QUALIFICATIONS REQUIRED:
Education/Experience: Bachelor’s degree in related field (preferred); five (5) or more years related experience; or equivalent combination of education and experience.
Knowledge, Skills and Abilities:
- Technical knowledge of statutory regulations and medical terminology.
- Analytical skills.
- Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff.
- Ability to interact with persons at all levels in the business environment.
- Ability to independently and effectively manage very complex claims.
- Proficient in Word and Excel (preferred).
Other Qualifications:
- Certifications and/or licenses as required by State regulation.
Here are some of the benefits you can enjoy in this role:
- Medical, Dental, Vision, Disability & Life Insurance
- 401(k) plan
- Paid time off
- Paid holidays
-
Workers Compensation Claims Analyst
4 days ago
Concord, New Hampshire, United States Mary Kraft HR Full timeAbout the RoleWe are looking for a skilled Workers Compensation Claims Analyst to join our team at Mary Kraft HR. The successful candidate will have experience in analyzing and processing complex workers' compensation claims.Analyze and process complex claims by investigating and gathering information.Develop and manage claims through structured action...
-
Workers Compensation Specialist
7 days ago
Concord, California, United States National Computer Systems Full timeWe are looking for a highly motivated Workers Compensation Specialist to join our team.This is a Temp to Perm position with a competitive salary range of $90,000 - $95,000.The ideal candidate will have experience in workers' compensation claims examination and administration.About the role:In-office/remote/hybrid position with a minimum of two days in the...
-
Insurance Claims Adjuster
7 days ago
Concord, Virginia, United States Auto-Owners Insurance Full timeJob OverviewThe Field Claims Representative role at Concord Insurance Group is a challenging and rewarding opportunity for individuals who want to make a difference in people's lives. Our team of caring associates creates financial security by helping individuals and businesses recover from losses.This field-based position requires travel to loss sites to...
-
Sr. Executive General Adjuster
2 days ago
Concord, United States Sedgwick Full timeTaking care of people is at the heart of everything we do, and we start by taking care of you, our valued colleague. A career at Sedgwick means experiencing our culture of caring. It means having flexibility and time for all the things that are important to you. It’s an opportunity to do something meaningful, each and every day. It’s having support for...
-
Claims Examiner Specialist
4 days ago
Concord, New Hampshire, United States Mary Kraft HR Full timeJob DescriptionMary Kraft HR is seeking an experienced Compensation Insurance Examiner to analyze complex workers' compensation claims. The role involves managing high-exposure claims, ensuring ongoing adjudication within service expectations and industry best practices.Analyze and process complex workers' compensation claims by investigating and gathering...
-
Hybrid Claims Analyst
7 days ago
Concord, California, United States National Computer Systems Full timeJob Overview:We are seeking a highly skilled Claims Examiner to join our team at National Computer Systems.The successful candidate will have experience in workers' compensation claims examination and possess strong analytical and communication skills.You will work closely with our team to manage a caseload of workers' compensation files, administer...
-
Property and Liability Adjuster
5 days ago
Concord, New Hampshire, United States Property Claim Professionals Full timeAs a Property and Liability Adjuster, you will play a critical role in helping us deliver exceptional claims service to our clients. With a focus on commercial and residential property losses, you will be responsible for handling claims from start to finish, including field inspections, investigations, and reserve recommendations.To be successful in this...
-
Compensation Insurance Examiner
4 days ago
Concord, New Hampshire, United States Mary Kraft HR Full timeJob SummaryMary Kraft HR is seeking a qualified Compensation Insurance Examiner to manage high-exposure workers' compensation claims. The successful candidate will have expertise in insurance principles, claim duration, and medical management practices.Analyze and process complex claims by investigating and gathering information.Develop and manage claims...
-
Claims Examiner III
7 days ago
Concord, United States National Computer Systems Full timeHello,Claims Examiner III Location – Concord, CA - Hybrid Duration : Contract to Hire JD : Workers’ Compensation Claims Examiner III position in Concord CA (Hybrid Position). This is an In-office/remote/hybrid position. (At least two days in the office)This is a Temp to Perm Position.The salary range for this position is $90,000 - $95,000The caseload...
-
Claims Examiner III
2 days ago
Concord, United States National Computer Systems Full timeHello,Claims Examiner III Location – Concord, CA - Hybrid Duration : Contract to Hire JD : Workers’ Compensation Claims Examiner III position in Concord CA (Hybrid Position). This is an In-office/remote/hybrid position. (At least two days in the office)This is a Temp to Perm Position.The salary range for this position is $90,000 - $95,000The caseload...
-
Claims Examiner III
2 days ago
Concord, United States National Computer Systems Full timeHello,Claims Examiner III Location – Concord, CA - Hybrid Duration : Contract to Hire JD : Workers’ Compensation Claims Examiner III position in Concord CA (Hybrid Position). This is an In-office/remote/hybrid position. (At least two days in the office)This is a Temp to Perm Position.The salary range for this position is $90,000 - $95,000The caseload...
-
Residential and Commercial Field Adjuster
4 days ago
Concord, New Hampshire, United States Property Claim Professionals Full timeWe are seeking a highly skilled Residential and Commercial Field Adjuster to join our team at Property Claim Professionals. As a leading provider of claims outsource solutions, we offer a challenging and rewarding work environment that is perfect for those who thrive in a fast-paced setting.The ideal candidate will possess excellent analytical and...
-
Contract Claims Examiner
7 days ago
Concord, California, United States National Computer Systems Full timeKey Responsibilities:Examine workers' compensation claims to determine eligibility and entitlement to benefits.Administer benefits, including medical treatment and medical billing, in accordance with company policies and procedures.Ensure compliance with all relevant laws, regulations, and industry standards.Maintain accurate records and reports, as...
-
concord, United States National Computer Systems Full timeHello,Claims Examiner III Location – Concord, CA - Hybrid Duration : Contract to Hire JD : Workers’ Compensation Claims Examiner III position in Concord CA (Hybrid Position). This is an In-office/remote/hybrid position. (At least two days in the office)This is a Temp to Perm Position.The salary range for this position is $90,000 - $95,000The caseload...
-
Claims Resolution Specialist
7 days ago
Concord, New Hampshire, United States Plymouth Rock Assurance Full timeAbout Plymouth Rock AssurancePlymouth Rock Assurance and its affiliated group of companies write and manage over $2 billion in personal and commercial auto and homeowners insurance throughout the Northeast and mid-Atlantic. We continuously invest in technology, empower our employees, and foster a supportive and inclusive workplace culture. Our company holds...
-
Insurance Industry Professionals Wanted
7 days ago
Concord, California, United States Sedgwick Full time**Job Description**We're seeking a skilled Claims Representative to join our team. As a Claims Representative, you'll process low-level workers compensation claims, determine compensability and benefits due, and ensure ongoing adjudication of claims within company standards and industry best practices.You'll develop and coordinate action plans to resolution,...
-
Travel Nurse RN
2 days ago
Concord, United States TalentBurst, Inc Full timeJob DescriptionTalentBurst, Inc is seeking a travel nurse RN Manager for a travel nursing job in Concord, Massachusetts.Job Description & RequirementsSpecialty: ManagerDiscipline: RNStart Date: 04/01/2025Duration: 15 weeks40 hours per weekShift: 8 hours, daysEmployment Type: Travel Employee Health Nurse Manager Education: Graduate of an accredited Nurse...
-
Sr. Applications Engineer
15 hours ago
Concord, United States Steven Douglas Corp Full timeJob DescriptionJob DescriptionBring Your Technical Expertise to Steven Douglas Corp (SDC)At SDC, we specialize in designing and building custom automated machines that serve a wide variety of applications and industries. As a family-owned and growing business, we are committed to delivering innovative solutions by blending proven engineering principles with...
-
Sr. Applications Engineer
1 day ago
Concord, United States Steven Douglas Corp Full timeBring Your Technical Expertise to Steven Douglas Corp (SDC)At SDC, we specialize in designing and building custom automated machines that serve a wide variety of applications and industries. As a family-owned and growing business, we are committed to delivering innovative solutions by blending proven engineering principles with creative approaches to...
-
Commercial Lines Specialist
7 days ago
Concord, Virginia, United States Auto-Owners Insurance Full timeRequirements and QualificationsTo be successful in this role, you will need to possess the following skills and qualifications:Bachelor's degree preferred or several years of direct experience5-7 years of experience handling Property Claims; Commercial Lines experience a plusStrong understanding of personal and commercial lines policy forms and coverage...