- 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.
- 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.
-
Workers Compensation Claims Adjuster III
4 weeks ago
Intercare Holdings Insurance Services, Inc. Rocklin, United StatesJob Type · Full-time · 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 ...
-
Workers Compensation Adjuster
4 weeks ago
Intercare Holdings Insurance Services Rocklin, United StatesClaims Adjuster III · Position posted onApril 29, 2022 · Claims Adjuster III Several positions available in Glendale, CA · 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 acco ...
-
BCBA / Behavior Analyst Remote
2 weeks ago
BURNETT THERAPEUTIC SERVICES INC Rocklin, United States Full timeJob description · The BCBA position will be held by an individual who has the training, education, and/or experience necessary to serve as the Qualified Autism Service Professional. This position will provide clinical supervision as well as oversight to the programs being impleme ...
-
Accounting Analyst
2 weeks ago
AgWest Farm Credit Rocklin, United StatesAgWest Farm Credit is a member-owned financial cooperative that provides financing and related services to farmers, ranchers, agribusinesses, commercial fishermen, timber producers, rural homeowners and crop insurance customers in a seven-state territory in the Western United Sta ...
-
Workers Compensation Adjuster
2 weeks ago
Intercare Insurance Rocklin, United StatesJob Description · Job DescriptionClaims Adjuster IIIPosition posted on April 29, 2022 · Claims Adjuster IIISeveral positions available in Glendale, CA · SummaryReports directly to the unit Claims Supervisor and may be called upon to provide technical backup in the absence of the ...
-
Groundskeeper I
1 week ago
Rocklin Unified School District Rocklin, United StatesAbout the Employer · The mission of Rocklin Unified School District, the cornerstone and leader of educational excellence, is to ensure each student becomes a well-rounded individual who thrives intellectually and develops unique strengths to pursue and achieve personal ambition ...
-
BURNETT THERAPEUTIC SERVICES INC Loomis, United StatesJob Description · Job DescriptionBenefits:401(k) · Bonus based on performance · Competitive salary · Dental insurance · Employee discounts · Health insurance · Opportunity for advancement · Paid time off · Parental leave · Training & development · Vision insurance · **Seeking a B ...
-
Sonographer, General and Vascular
2 weeks ago
Sutter Health Roseville, United StatesOrganization: · SMF-Sutter Med Foundation- Central · Position Overview: · Expertly performs routine and specialized sonography procedures of high complexity to produce quality images to physicians and other health care providers for the diagnosis, treatment, monitoring and preven ...
-
Mammography Technologist
2 weeks ago
Sutter Health Roseville, CA, United StatesSutter Health is seeking a Mammography Technologist for a job in Roseville, California. · Job Description & Requirements · Specialty: Mammography Technologist · Discipline: Allied Health Professional · Start Date: ASAP · Duration: Ongoing · Employment Type: Staff · We are so glad ...
-
Vascular Sonographer
2 days ago
Sutter Health Roseville, United StatesSutter Health is seeking a Vascular Sonographer for a job in Roseville, California. · Job Description & Requirements · Specialty: Vascular Sonographer · Discipline: Allied Health Professional · Start Date: ASAP · Duration: Ongoing · Employment Type: Staff · We are so glad ...
-
Level III
3 weeks ago
Sutter Health Roseville, United StatesSutter Health is seeking a Pharmacist Level III for a job in Roseville, California. · Job Description & RequirementsSpecialty: Pharmacist · Discipline: Allied Health Professional · Start Date: ASAP · Duration: Ongoing · Employment Type: Staff · We are so glad you are interes ...
-
Sonographer III
4 weeks ago
Kaiser Permanente Roseville, United StatesJob Summary: · Under the direction of the Imaging Services Director and Chief of Radiology/ Imaging Services, or other Clinical Service Director where applicable, produces two-dimensional ultrasonic recordings of internal organs for use by Physician in diagnosis of disease and st ...
-
Central Operations Service Representative II-III
2 weeks ago
Poppy Bank Roseville, United StatesJob Type · Full-time · Description · We are building a second Central Operations Team located in Roseville Depending on experience, you could be the next Central Operations Service Representative II or III. Please see below for more details and we look forward to connecting wit ...
-
Materials Program Manager II-III
1 day ago
Kratos Defense Roseville, United StatesKratos Defense & Security Solutions, Inc., is a leading defense technology company focused on unmanned systems, satellite communications, cyber security/warfare, microwave electronics, missile defense, training, and combat systems. Our customers include the U.S. federal governmen ...
-
Workers Compensation Adjuster
1 week ago
Intercare Holdings Insurance Services Rocklin, United StatesClaims Adjuster III · Position posted onApril 29, 2022 · Claims Adjuster III Several positions available in Glendale, CA · 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 acco ...
-
Workers Compensation Adjuster
2 weeks ago
Intercare Insurance Services Rocklin, United StatesClaims Adjuster III · Position posted on April 29, 2022 · Claims Adjuster III · Several positions available in Glendale, CA · Summary · Reports directly to the unit Claims Supervisor and may be called upon to provide technical backup in the absence of the Claims Supervisor. ...
-
Workers Compensation Claims Adjuster
4 weeks ago
Intercare Holdings Insurance Services Rocklin, United StatesWorkers Compensation Claims Adjuster III · Job Details · Job Type · Full-time · Rocklin, CA · 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 w ...
-
Accounting Analyst
4 weeks ago
AgWest Farm Credit Rocklin, United StatesAgWest Farm Credit is a member-owned financial cooperative that provides financing and related services to farmers, ranchers, agribusinesses, commercial fishermen, timber producers, rural homeowners and crop insurance customers in a seven-state territory in the Western United Sta ...
-
Level III
2 weeks ago
Sutter Health Loomis, CA, United StatesSutter Health is seeking a Nuclear Medicine Technologist Level III for a job in Loomis, California. · Job Description & Requirements · Specialty: Nuclear Medicine Technologist · Discipline: Allied Health Professional · Start Date: ASAP · Duration: Ongoing · Employment Type: Staff ...
-
Level III
2 weeks ago
Sutter Health Citrus Heights, CA, United StatesSutter Health is seeking a Nuclear Medicine Technologist Level III for a job in Citrus Heights, California. · Job Description & Requirements · Specialty: Nuclear Medicine Technologist · Discipline: Allied Health Professional · Start Date: ASAP · Duration: Ongoing · Employment Typ ...
Temp Claims Adjuster III - Rocklin, United States - Intercare Holdings Insurance Services, Inc.
Description
Job Type
Full-time, Temporary
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:
Competency:
To perform the job successfully, an individual should demonstrate the following competencies:
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.