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Claims Examiner

Adecco is assisting a local client recruiting for Claims Examiner jobs. This is a temp opportunity in California, remote **in CA** .

This position requires candidates to have a minimum of 3+ years as a claims examiner handling CA Claims Worker’s Compensation (WC) experience. Prior public entity experience is preferred but not required. SIP is a plus. If you meet the qualifications listed below, apply now!

Responsibilities for a Claims Examiner include but are not limited to:

+ Analyzing mid- and higher-level workers compensation claims to determine benefits due.

+ Ensuring ongoing adjudication of claims within company standards and industry best practices.

+ Identifying subrogation of claims and negotiating settlements.

+ Managing workers compensation claims determining compensability and benefits due on long term indemnity claims.

+ Monitoring reserve accuracy and filing necessary documentation with state agency.

+ Developing and managing workers compensation claims' action plans to resolution.

+ Coordinating return-to-work efforts and approving claim payments.

+ Approving and processing assigned claims, determining benefits due, and managing action plan pursuant to the claim or client contract.

+ Communicating claim action with claimant and client.

+ Ensuring claim files are properly documented and claims coding is correct.

+ Processing complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

+ Maintaining professional client relationships.

+ Supporting the organization's quality program(s).

+ Traveling as required.

Candidates must meet the following requirements to be considered:

+ Bachelor's degree from an accredited college or university preferred.

+ Four (4) years of claims management experience or equivalent combination of education and experience required.

+ Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business.

+ PC literate, including Microsoft Office products.

What's in this for you?

+ Pay starting at $46.42 per hour.

+ Work Hours: 8 AM - 4:30 PM.

+ Weekly paycheck.

+ Access to Adecco’s Aspire Academy with thousands of free upskilling courses.

Click apply to be considered for this Claims Examiner job in California!

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**Pay Details:** $46.42 per hour

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.adecco.com/en-us/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

+ The California Fair Chance Act

+ Los Angeles City Fair Chance Ordinance

+ Los Angeles County Fair Chance Ordinance for Employers

+ San Francisco Fair Chance Ordinance