Senior Workers' Compensation Claims Examiner
5 days ago
Keenan is a leading insurance brokerage and consulting firm serving hospitals, public agencies, and California school districts. Specializing in employee benefits, workers' compensation, loss control, financial services, and property & liability, Keenan is committed to delivering innovative solutions that protect and empower the communities we serve.
As part of Gallagher, a global leader in insurance, risk management, and consulting, you'll be joining a team that's passionate about helping individuals and organizations thrive.
Overview:
Administer indemnity claims and handle complex claim issues. Use strong litigation management experience, lien resolution abilities, and customer service skills to resolve routine claims without legal representation.
What You'll Do:
- Maintain current diary.
- Identify, prevent and mitigate potential penalties.
- Update claim notes in computer.
- Provide timely reporting of excess files to the Reinsurance Manager.
- Report SIU/Fraud.
- Identify and pursue subrogation.
- Complete Rehab forms/benefit notices/SJDB/RTW form.
- Refer all PRIME deletions only to office designee.
- Update reserves no later than 30 days of receipt of information modifying the financial exposure of a claim.
- Prepare for and attend file reviews.
- Accept or deny delayed claims within 90 days.
- Request settlement authorization/notification within 30 days of a final P&S report and prior to the MSC date.
- Complete Stipulation and/or Compromise and Release paperwork.
- Maintain 100% closing ratio on active accounts and reduce run off accounts by 25% annually.
- Prepare legal referrals, provide direction to and monitor defense attorney.
- Return all phone calls within 24 hours.
- Complete instruction sheets for Assistant/Technician/Claims entry clerk.
- Review mail daily.
- Correct error report daily.
- Maintain client/claimant satisfaction.
- Update Unit Stat forms.
- Oversee new set-ups, reserves and instruction sheets.
- Prepare cover letters to AME/defense QME, AOE/COE evaluations.
- Negotiate outstanding liens.
- Make 3-point contact.
- File Answer/Application.
- Interaction with nurse on case management.
- Other duties assigned.
Compensation and benefits
We offer a competitive and comprehensive compensation package. The target salary range for this position is $75,000.00 to $105, US Dollar) annually. The base salary range represents the anticipated low end and high end of the range for this position. The actual compensation will be influenced by a wide range of factors including, but not limited to previous experience, education, pay market/geography, complexity or scope, specialized skill set, lines of business/practice area, supply/demand, and scheduled hours. On top of a competitive salary, great teams and exciting career opportunities, we also offer a wide range of benefits.
Below are the minimum core benefits you'll get, depending on your job level these benefits may improve:
- Medical/dental/vision plans, which start from day one
- Life and accident insurance
- 401(K) and Roth options
- Tax-advantaged accounts (HSA, FSA)
- Educational expense reimbursement
- Paid parental leave
Other benefits include:
- Digital mental health services (Talkspace)
- Flexible work hours (availability varies by office and job function)
- Training programs
- Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
- Charitable matching gift program
- And more...
**The benefits summary above applies to fulltime positions. If you are not applying for a fulltime position, details about benefits will be provided during the selection process.
What You'll Need:
- Minimum of five (5) years of claims handling in Workers' Compensation or relevant insurance industry, required.
- Self-Insurance Certificate required, or willingness to obtain within one (1) year of hire.
- Experience in handling public entity claims a plus.
- Effective in verbal and written communication.
- Proficient in Microsoft Outlook, Excel, PowerPoint and Word.
Job Type: Full-time
Pay: $75, $105,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible schedule
- Flexible spending account
- Health insurance
- Health savings account
- Life insurance
- Paid time off
- Professional development assistance
- Referral program
- Retirement plan
- Tuition reimbursement
- Vision insurance
Work Location: Remote
-
Medicare Senior Claims Examiner
6 days ago
Los Angeles, California, United States Impresiv Health Full timeMedicare Senior Claims ExaminerDescription:This position is responsible for: researching, correcting and responding to all D-SNP pended claims as well the review of Audit reports in a timely manner; determining whether a claim should be paid (in accordance with the policies and procedures) and maintaining correspondence for document procedure /medical/CPT/...
-
Claims Examiner
2 days ago
Los Angeles, California, United States Sedgwick Full timeBy joining Sedgwick, you'll be part of something truly meaningful. It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there's no limit to what you can achieve.Newsweek Recognizes Sedgwick as...
-
Sr. Claims Adjuster, Workers' Compensation
1 week ago
Los Angeles, California, United States CopperPoint Insurance Companies Full time $85,000 - $105,000 per yearCopperPoint Insurance Company has an exciting opportunity for a full-time remote Sr. Claims Adjuster, Workers' Compensation. The Sr. Claims Adjuster, Workers' Compensation will investigate, manage, and resolve claims in a timely, unbiased, and informed manner in compliance with policies, state laws, and regulatory performance standards.Job...
-
Workers' Compensation Claims Supervisor
3 days ago
Los Angeles, California, United States AIMS Full timeSUMMARY OF RESPONSIBILITIESUnder the direction of the Workers' Compensation (WC) Claims Manager, the (WC) Supervisor has responsibility for the daily operations and activities of all (WC) claims staff assigned to their work unit. The position requires timely review and approval of the work product performed by their assigned personnel. In addition, the (WC)...
-
Claims Examiner
1 week ago
Los Angeles, California, United States Career Advocates Full timeThe Claims Examiner will be responsible for researching and resolving pending claims, reviewing claim denials requiring manual review, and ensuring timely processing in compliance with policies, procedures, and regulatory guidelines. The role involves determining claim payments, maintaining correspondence for procedural and medical coding, and adhering to...
-
Claims Adjuster
2 weeks ago
Los Angeles, California, United States State Compensation Insurance Fund Full time $50,000 - $90,000 per yearState Fund is hiring self-motivated individuals who thrive in a fast-paced environment. We offer exceptional training and career growth while making a meaningful difference in people's lives. Sound like you? Apply todayThis position may be filled in any of the following State Fund locations:Bakersfield, Eureka, Fresno, Oxnard, Pleasanton, Redding, Riverside,...
-
Hospital Claims Examiner
1 week ago
Los Angeles, California, United States MedPOINT Management Full time $60,000 - $90,000 per yearJob DescriptionThe claims examiner is responsible for the adjudication of claims, in accordance with outside regulations and the contractual obligations of the Health Plans and/or the Hospital Client. Researches, reviews and contacts provider services for problem claims and issues, as needed. Suggests process improvements to management and is a resource of...
-
Commercial Property Claims Examiner III
4 days ago
Los Angeles, California, United States California FAIR Plan Association Full timePOSITION SUMMARYThe Commercial Property Claims Examiner III reviews, evaluates and processes complex commercial insurance claims and makes recommendations for resolution. Additionally, this role will examine and authorize commercial insurance claims investigated by independent adjusters. Lastly, the commercial property examiner will review claim forms and...
-
deputy county counsel workers' compensation
2 weeks ago
Los Angeles, California, United States County of Los Angeles Full time $120,000 - $180,000 per yearPosition/Program InformationEXAM NUMBERU9206ZTYPE OF RECRUITMENTOpen Competitive Job OpportunityFIRST DATE OF FILINGWednesday, November 20, 2024, at 8:00 a.m. (PT)THIS EXAMINATION WILL REMAIN OPEN UNTIL THE NEEDS OF THE SERVICEARE MET AND IS SUBJECT TO CLOSURE WITHOUT PRIOR NOTICE.ABOUT THE LOS ANGELES COUNTY OFFICE OF THE COUNTY COUNSEL:The Office of the...
-
Claim Director
7 days ago
Los Angeles, California, United States Chubb Insurance Full timeChubb is currently seeking a Workers' Compensation Lost Time Claim Director for our West Coast/Pacific region. The successful applicant will be handling claims from California. The position will report and reside in our Los Angeles, CA office.Duties & Responsibilities:Handles all aspects of workers' compensation lost time claims from set-up to case closure...