- To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.
- Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
- Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
- Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
- Manages subrogation of claims and negotiates settlements.
- Communicates claim action with claimant and client.
- Ensures claim files are properly documented and claims coding is correct.
- May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.
- Maintains professional client relationships.
- Performs other duties as assigned.Supports the organization's quality program(s).
- Travels as required.
- Work location: prefer onsite, but will accept remote (within CA) or hybrid.
- Years of experience: 2 years plus Prefer a college degree
- Requires WC Claims experience
- Prefer SIP certificate
-
Claims Examiner
1 week ago
BCforward Signal Hill, United StatesClaims Examiner - Workers Compensation · BCForward is looking for Claims Examiner- Workers Compensation at CA (Remote) · Position Title:Claims Examiner - Workers Compensation · Location: Long Beach, CA Remote) · Anticipated Start Date: ASAP · Expected Duration: 4+ Months Contra ...
-
Claims Examiner
3 days ago
Rose International Long Beach, United States**Only those lawfully authorized to work in the designated country associated with the position will be considered.** · **Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.* ...
-
Examiner, Claims
1 week ago
Molina Healthcare Long Beach, United StatesJob Description · JOB DESCRIPTION · Job Summary · Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards. · ...
-
Claims Examiner
3 weeks ago
Experis Long Beach, United StatesJob Title: Workers Compensation Claims Examiner · Contract: 6 months · $45hr · Location: Onsite preferred, Remote (within CA) or Hybrid considered · PRIMARY PURPOSE: · Analyze mid- and higher-level workers' compensation claims to determine benefits due, ensure ongoing adjud ...
-
Examiner, Claims
2 weeks ago
Molina Healthcare Long Beach, United StatesJob Summary · Responsible for administering claims payments, maintaining claim records. Monitors and controls backlog and workflow of claims. Ensures that claims are settled in a timely fashion and in accordance with cost control standards. · KNOWLEDGE/SKILLS/ABILITIES · Evaluate ...
-
Workers Compensation Claims Examiner
1 week ago
Sedgwick Long Beach, United StatesTaking 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 opportuni ...
-
Claims Examiner
1 week ago
E-Solutions Whittier, United StatesPOSITION SUMMARY: · The claims examiner reports directly to the claims manager. They are primarily responsible for the processing functions (operation, adjudication, and payment) of UB-92 and HCFA-1500 claims that are received from PHP affiliated medical groups and hospitals for ...
-
Claims Examiner
3 weeks ago
Innovative Management Systems Incorporated Whittier, United States:The Position. · We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider contracts. Experience in adjudication of Com ...
-
Medical Claims Examiner III
4 days ago
Ultimate Staffing Services Long Beach, United StatesParameters of the provider's contract obligations. Audit claims processing quality, develops, maintains and runs standard reports. Assist the Claims Supervisor/ Director in reviewing the quality auditing tracking/reporting (financial and procedura Medical, Examiner, Claims, Claim ...
-
Workers Compensation Claims Examiner
3 days ago
Sedgwick Long Beach, United StatesTaking 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 opportuni ...
-
Claims Examiner
1 week ago
BCforward Brea, United StatesBCforward is looking for Claims Examiner - Workers Compensation @ Brea, CA 92821. · Position: Claims Examiner - Workers Compensation · Location: Brea, CA 92821 · Pay-Rate: $50/Hr. on W2 · PRIMARY PURPOSE: · To analyze complex or technically difficult workers' compensation claims ...
-
Claims Examiner
3 weeks ago
Innovative Management Systems, Inc. La Puente, United StatesJob Type · Full-time · Description · The Position. · We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider contr ...
-
Claims Examiner
1 week ago
Manpower Inc Manhattan Beach, United StatesOur client, Legal Industry is seeking a Claims Examiner to join their team. As a Legal Claims Examiner you will be part of the Restructuring services supporting Restructuring services department. The ideal candidate will have Research, Administration and Analytical skills which w ...
-
Claims Examiner
2 weeks ago
Experis Pasadena, United StatesJob Title: Workers Compensation Claims Examiner · $47.85hr · 5 Month contract with opportunity for extension · Must Have Requirements: · - Must Reside in CA. Can be hybrid or remote · - 6 years plus Experience · - College degree · - 6+ yrs workers' compensation claims experience. ...
-
Claims Examiner
2 weeks ago
Innovative Management Systems Incorporated City of Industry, CA, United States Full time: The Position. · We are looking for a detail-oriented individual that can accurately review, research, and analyze professional claims to determine and calculate the type and level of benefits based on established criteria and provider contracts. Experience in adjudication of ...
-
Claims Examiner
2 weeks ago
Techlink Systems Brea, United StatesJob Description · Job DescriptionJob Title: Claims Examiner - Workers Compensation · Location: Brea, CA (Remote) · Contract Duration: Contract until 09/14/2024 with possibility to extend/convert to full time · PRIMARY PURPOSE: · To analyze complex or technically difficult workers ...
-
Claims Examiner
4 days ago
North American Staffing Group Montebello, United StatesJob Description · Job DescriptionPosition Type: Direct HireLocation: Montebello, CA (Hybrid after initial training onsite is completed)Hourly Rate: $24 - 30/HR depending on years of experienceSchedules Available: 6AM - 3PM, 7AM - 4PM, 8AM - 5PM · Requirements:Minimum 2 - 3 years ...
-
Claims Examiner
4 days ago
MedPOINT Management Los Angeles, United StatesJob Description · Summary: · Accurately handle, process and assess provider specialty claims, such as UB04s, following external regulations, internal standards, and contractual commitments. Understanding of medical terminology is crucial. Profound knowledge of Commercial, Medicar ...
-
Medical Claims Examiner
2 weeks ago
SCUFCW Trust Fund Cypress, United StatesJob Description · Job DescriptionSouthern California United Food & Commercial Workers Unions & Food Employers Joint Benefit Funds Administration, LLC (The Funds) were created more than 40 years ago as a result of collective bargaining between the Southern California Retail Food E ...
-
Claims Examiner
1 week ago
LanceSoft Brea, United StatesJob Description:To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best pract ...
Claims Examiner - Signal Hill, United States - BCforward
Description
Claims Examiner - Workers Compensation
BC Forward is looking for Claims Examiner - Workers Compensation Located at Long Beach, CA Remote)
Position Title: Claims Examiner - Workers Compensation
Locations: Long Beach, CA Remote)
Anticipated Start Date: 05/06
Expected Duration: 7+ months contract
Estimated Sart Date:-05/20/2024
Job Type: Contract with possible extension
Pay Rate: $60.00 /hr on W2.
PRIMARY PURPOSE:
BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.
About BCforward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.
BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.
To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.
This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.
Interested candidates please send resume in Word format Please reference job code when responding to this ad.
