- 2+ years workers comp claims experience
- Bachelor's degree required
- Prefer SIP certificate
- 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.
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Claims Examiner - Los Angeles, United States - Total Medical Staffing
Description
Job Description
Job DescriptionPosition Title – Claims Examiner - Workers Compensation
Address – Remote CA
Pay $40/HR
Start date – ASAP
Hours – 8a-5p
Required Skills & Education:
Position Purpose:
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.
Responsibilities:
Company DescriptionIn the rapidly-changing, highly regulated industry that is healthcare, you need a medical staffing partner who works for you.
Enter TotalMed. We're an award-winning medical staffing agency delivering flexible healthcare staffing solutions no matter how complex your needs. But even more than that, we're a team who really cares. Our end goal is to achieve quality patient care while enhancing your employee morale.If you're a healthcare professional in either clinical or non-clinical healthcare, our recruiters can help you navigate the sea of healthcare jobs, uncovering your ideal career path.
Or, if you're faced with open positions and short-staffed projects in either business care or patient care, TotalMed can provide customized medical staffing solutions to fulfill your hiring requirements.
Company Description
In the rapidly-changing, highly regulated industry that is healthcare, you need a medical staffing partner who works for you.\r\r
Enter TotalMed. We're an award-winning medical staffing agency delivering flexible healthcare staffing solutions no matter how complex your needs. But even more than that, we're a team who really cares. Our end goal is to achieve quality patient care while enhancing your employee morale.\r
\r
If you're a healthcare professional in either clinical or non-clinical healthcare, our recruiters can help you navigate the sea of healthcare jobs, uncovering your ideal career path.
\r\r
Or, if you're faced with open positions and short-staffed projects in either business care or patient care, TotalMed can provide customized medical staffing solutions to fulfill your hiring requirements.
