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Claims Examiner - Long Beach, United States - Rose International
Description
Date Posted: 05/09/2024
Hiring Organization: Rose International
Position Number: 463794
Job Title: Claims Examiner
Job Location: Long Beach, CA, USA, 90806
Work Model: Hybrid
Employment Type: Temporary
Estimated Duration (In months): 8
Min Hourly Rate ($): 60.00
Max Hourly Rate ($): 60.00
Must Have Skills/Attributes: Claims, Document Review, Negotiation
Job Description
**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. **
***Only qualified Claims Examiner candidates located in the Long Beach, CA areas will be considered due to the position requiring an onsite presence***
The client is seeking a qualified Claims Examiner to analyze mid- and higher-level workers compensation claims to determine benefits due, ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.
Required Experience:
• 2 years plus Workers Compensation Claims experience
Preferred Education/Certifications:
• Prefer a college degree
• Prefer SIP certificate
Essential Functions and Responsibilities:
• 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
Additional Functions and Responsibilities:
• Performs other duties as assigned
• Supports the organization's quality program(s)
• Travels as required
Benefits:
For information and details on employment benefits offered with this position, please visit here. Should you have any questions/concerns, please contact our HR Department via our secure website.
California Pay Equity:
For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here.
