Top 16 Claims adjuster Jobs in Avalon, Ca

Workers' Compensation Claims Adjuster - III
Professional Search —California
- Up to $60 an hour
- Temporary
- Remote
- 5 years
- Conflict management
- Senior level
- Health savings account
- Health insurance
Quick Apply
Workers' Compensation Claims Adjuster - Northern California
Insurance Relief —California
- $90,000 - $100,000 a year
- Full-time
- Remote
- 5 years
- Organizational skills
- Senior level
- Paid holidays
- Health insurance
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Senior Workers' Compensation Claims Adjuster (Must have active experience)
Kindred Resource Group —California
- $95,000 - $102,000 a year
- Full-time
- 5 years
- Writing skills
- Bachelor's degree
- Health savings account
- Health insurance
Quick Apply
Auto PD Adjuster
TheBest Claims Solutions —United States
- $35 an hour
- Temporary
- Mid-level
- 3 years
- Commercial
- Work from home
Senior General Liability Litigation Specialist
TheBest Claims Solutions —United States
- $85,000 - $110,000 a year
- Remote
- Senior level
- 2 years
- Commercial

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claims adjuster jobs near avalon, ca

Workers' Compensation Claims Adjuster - III

Professional Search -
California

Quick Apply

Job Details

Temporary | Temp-to-hire | Full-time | Contract
Up to $60 an hour

Benefits

Health savings account
Health insurance
Dental insurance
401(k)
Flexible spending account
Tuition reimbursement
Paid time off
Family leave
Work from home
Parental leave
Vision insurance
401(k) matching
Professional development assistance
Flexible schedule
Life insurance
Referral program
Retirement plan

Qualifications

Teamwork
Workers' compensation insurance knowledge
Litigation
Conflict management
Medical management
Fraud prevention and detection
Bachelor of Arts
California labor law

Full Job Description

Summary:

Reports directly to the unit Claims Supervisor and may be called upon to provide technical backup in the absence of the Claims Supervisor. In accordance with applicable statutes and in keeping with company rules, regulations, and established performance objectives, is responsible for effectively managing to conclusion an assigned inventory of claim files that may include cases of extreme complexity or with unique or unusual issues.

Essential Duties and Responsibilities:

Perform a three-point contact on all new losses within 24 hours of receipt of the claim to include the claimant, employer, and treating physician to document relevant facts surrounding the incident itself as well as disability and treatment status.
Thoroughly and accurately document ongoing case facts and relevant information necessary for establishing compensability, the need for disability payments, the use of vendors, medical and expense payments, and what is being done to move the case toward closure.
Assure that all assigned indemnity claims have an up to date plan of action outlining activities and actions anticipated for ultimately resolving the claim.
Form a partnership with the medical case manager to maximize early return to work potential thereby reducing the need for extended disability payments, vocational rehabilitation, and other protracted claims costs.
Initiate the referral to the SIU of cases with suspected fraud.
Aggressively pursue subrogation from culpable third parties, contributions on multiple defendant cases, and apportionment when there is pre-existing disability.
Assure that the claim file is handled totally in accordance with applicable statutes as well as in-force service contracts and company guidelines.
Review and approve all vocational rehabilitation plans.
Establish, monitor, and adjust monetary case reserves when warranted and in strict accordance with assigned authority levels.
Review all medical bills for appropriateness prior to referral to InterMed for payment and posting to the claim file.
Exhibit and maintain a courteous and helpful attitude and project a professional image on behalf of the company.
Respond to telephone messages and inquiries within 24 hours of receipt and to written inquiries within one week of receipt.
Requires a working knowledge of the Labor Code of the State of California as it pertains to workers compensation claims and the legal requirements for handling them.
Litigation management - Direct, manage, and control the litigation process.
Handles other duties and tasks as deemed appropriate by the Supervisor or Manager.

Requirements

Competency:

To perform the job successfully, an individual should demonstrate the following competencies:

Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Uses reason even when dealing with emotional topics.
Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Responds to requests for service and assistance; Meets commitments.
Interpersonal - Focuses on solving conflict, not blaming; Maintains confidentiality; Listens to others without interrupting; Keeps emotions under control; Remains open to others' ideas and tries new things.
Team Work - Supports everyone's efforts to succeed.

Qualification Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience:

Bachelor's degree (B. A.) from four-year college or university; at least seven years related experience and/or training; or equivalent combination of education and experience. Requires a high degree of claims handling expertise to include a minimum of at least five years experience managing indemnity cases, many with complex or high potential subrogation, rehabilitation, medical management, and/or legal issues & possess an SIP certificate.

Pay: Up to $60.00 per hour

Benefits:

401(k)
401(k) matching
Dental insurance
Family leave
Flexible schedule
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Parental leave
Professional development assistance
Referral program
Retirement plan
Tuition reimbursement
Vision insurance
Work from home

Experience:

workers compensation claims adjusting : 2 years (Required)

Work Location: Remote

Quick Apply

Refine Your Search

claims adjuster jobs in avalon, ca

Workers' Compensation Claims Adjuster - III

Workers' Compensation Claims Adjuster - Northern California

Senior Workers' Compensation Claims Adjuster (Must have active experience)

Auto PD Adjuster

Senior General Liability Litigation Specialist

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