- 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
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Claims Examiner
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ManpowerGroup Los Angeles, 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 ...
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Claims Examiner III
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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 ...
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Claims Examiner
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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 ...
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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. ...
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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 ...
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Lead Medical Claims Examiner
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Medical Claims Examiner I
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Insight Global Los Angeles, United StatesA Medical Health Insurance Plan based in Los Angeles is in the immediate need of a Medical Claims Representative. The Medical Claims Representative will be responsible for speaking with members over the phone and troubleshooting any of the participants bills or claims. The Medica ...
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Medical Claims Examiner I
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Insight Global Los Angeles, United StatesA Medical Health Insurance Plan based in Los Angeles is in the immediate need of a Medical Claims Representative. The Medical Claims Representative will be responsible for speaking with members over the phone and troubleshooting any of the participants bills or claims. The Medica ...
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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.* ...
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BCforward Signal Hill, United StatesClaims 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 D ...
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:
