- Under technical direction, works within significant limits and authority on assignments of higher technical complexity and coordination.
- Responsible for Workers' Compensation Claims management of assigned cases within guidelines of published performance standards.
- Opens new Workers' Compensation Claims, completes three-point contact, and performs needed investigations to determine compensability as well as possible subrogation or apportionment, according to state and/or Zenith's timeframes and guidelines.
- Sets appropriate reserves according to Zenith's timeframes and guidelines.
- Follows appropriate procedures for system documentation to preserve data integrity.
- Monitors and maintains accuracy of reserves over the life of the claim; when new information is received re-evaluates and recommends reserves according to Zenith's standards.
- Creates and executes action plans needed to bring case to closure.
- Completes detailed Workers' Compensation settlement evaluations and recommends appropriate settlement value, within authority; negotiates claim settlements with injured workers and/or injured workers' attorneys.
- Maintains regular contact with injured workers, employers and agents to develop positive relationships and establish credibility.
- Apply principles of logical thinking to define problems, collect data, establish facts, and draw valid conclusions.
- Works productively and harmoniously with others on a consistence basis.
- Respond positively to direction and criticism of performance.
- Consistently maintain professional and appropriate demeanor.
- Perform other duties as assigned.
- High School Diploma Or equivalent required
- Bachelor's Degree or equivalent combination of training/experience preferred.
- 1+ Years claims or insurance experience preferred. Previous workers' compensation experience required.
- Basic technical workers' compensation Claims knowledge.
- Strong verbal and written communication skills with emphasis on telephone communication required.
- Strong math and reading skills required.
- Meets all state regulatory standards regarding licensing, continuing education, and other requirements.
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Claims Specialist
10 hours ago
Liberty Mutual Insurance Rocklin, United StatesSchedule: Full-Time Salary Range: USD $ $ Job Category: Claims Pay Philosophy The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects th ...
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Senior Workers' Compensation Claims Specialist
44 minutes ago
The Ladders Rocklin, United StatesPay Philosophy · The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these p ...
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The Ladders Rocklin, United StatesPay Philosophy · The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these ...
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Liberty Mutual Insurance Rocklin, United StatesPay Philosophy · The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these p ...
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Indemnity Claims Specialist
2 days ago
CorVel Folsom, United StatesAn Indemnity Claims Specialist is responsible for managing lower-level, non-complex and non-problematic indemnity claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims depar ...
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CA Claims Specialist
5 days ago
CorVel Corporation Folsom, United States Full timeThe Claims Specialist manages within company best practices lower-level, non-complex and non-problematic indemnity claims within delegated limited authority to best possible outcome, under the direct supervision of a senior claims professional, supporting the goals of claims depa ...
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CA Senior Claims Specialist
3 weeks ago
CorVel Enterprise Comp, Inc. Folsom, United StatesJob Description · Job DescriptionThe Senior Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to determine benefits due; work closely with case managers an ...
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Claims Operations Specialist
3 days ago
State of California Sacramento, United StatesDo you want to be part of a team who influences the delivery of superior claims outcomes? Are you an innovative individual that has the ability to inspire and influence a customer-centric culture? Are you passionate above doing the right thing? · If the answer is YES and you bel ...
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Complex Technical Claims Specialist II
3 weeks ago
Liberty Mutual Group Rocklin, United StatesInvestigates claims to determine whether coverage is provided, establish compensability and verify exposure. Resolves claims within authority and makes recommendations regarding case value and resolution strategy to Branch Office Management and HO Ex Workers Compensation, Claims ...
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Liberty Mutual Rocklin, United StatesPay Philosophy · The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these p ...
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Senior Claims Specialist
3 weeks ago
CorVel Folsom, United StatesCorVel is seeking a CA Workers Compensation Sr. Claims Specialist. The CA Workers Compensation Sr. Claims Specialist manages within company standards and best practices complex and problematic, high visibility workers' compensation claims within delegated limited authority to det ...
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Liberty Mutual Insurance Rocklin, United States OTHERPay PhilosophyThe typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these posi ...
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Liberty Mutual Insurance Rocklin, United States OTHERPay PhilosophyThe typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these posi ...
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CA Medical Only Claims Specialist
3 weeks ago
CorVel Enterprise Comp, Inc. Folsom, United StatesJob Description · Job DescriptionThe Medical Only Claims Specialist manages non-complex and non-problematic, medical only claims and minor lost-time workers' compensation claims under close supervision, supporting the goals of claims department and of CorVel. · This is a remote j ...
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Complex Technical Claims Specialist II
3 weeks ago
The Liberty Mutual Foundation Rocklin, United StatesPay Philosophy · The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these ...
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Complex Technical Claims Specialist II
2 weeks ago
Liberty Mutual Rocklin, United StatesPay Philosophy · The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these p ...
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Complex Technical Claims Specialist II
3 weeks ago
Liberty Mutual Insurance Rocklin, United StatesPay Philosophy · The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these p ...
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Liberty Mutual Rocklin, United States OTHERPay PhilosophyThe typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these posi ...
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Dental Claims Insurance Specialist
2 weeks ago
LHH Recruitment Solutions Sacramento, United StatesJob Description · Job DescriptionAre you passionate about providing exceptional customer service and ensuring smooth claims processing for dental patients? LHH Recruitment Solutions is seeking a Dental Claims Specialist for our esteemed client in the Sacramento area. This contrac ...
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Dental Claims Insurance Specialist
2 weeks ago
Lee Hecht Harrison Nederland B.V. Sacramento, United StatesAre you passionate about providing exceptional customer service and ensuring smooth claims processing for dental patients? LHH Recruitment Solutions is seeking a Dental Claims Specialist for our esteemed client in the Sacramento area. This contract opportunity offers the chance t ...
Workers' Compensation Claims Specialist - Roseville, United States - Zenith
Description
Zenith is a team of Workers' Compensation Specialists committed to helping businesses succeed by protecting against the financial and human consequences of workplace injuries, providing for the needs of injured employees and making the workplace safer. To distinguish ourselves as the desired provider of Workers' Compensation Insurance, values such as collaboration, work-life balance, and integrity are placed at the center of all our operations. In addition, Zenith supports career advancement through a dedication to ongoing learning and development. An individual coming to Zenith will not only receive competitive compensation and a comprehensive benefits package, but continuous opportunities to grow as a professional.
Investigate, analyze, and determine the extent of company's liability concerning Claims and attempt to effect settlement with claimants. Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information. Calculate benefit payments and approve payment of Claims within a certain monetary limit. All tasks are to be performed with the goal of demonstrating Zenith's superior Claims handling expertise.
The essential responsibilities of this position include, but are not limited to, the following:
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. If you are a qualified individual with a disability or a disabled veteran, you have the right to request an accommodation if you are unable or limited in your ability to use or access our career center as a result of your disability. To request an accommodation, contact a Human Resources Representative at Zenith Insurance Company.
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Workers' Compensation Claims Specialist professionals in Roseville
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Lily Cervantes
hard working and self motivated