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Has developed high level knowledge of Workers Compensation claims handling techniques, a full knowledge of LMG claims procedures and is cognizant of new industry trends and claim handling techniques Uses available data to track claims trends and other claim related metrics.
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Has developed a solid understanding of Workers Compensation claims handling techniques, generally as a result of progressing through the Case Manager job family. Under general supervision and established practices, responsible for the investigation, evaluation, and disposition of Complex Workers Compensation cases of moderate to high exposure.
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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.
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Responsibilities include: Handle General Liability / Bodily Injury, Property, Commercial Auto Liability and/or Physical Damage, Workers Compensation, Inland Marine, Professional / Management Liability, Business Interruption, Liquor Liability, Garage/Garagekeepers Legal Liability or Umbrella claims.
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PRIMARY PURPOSE : To process low 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 with general supervision.
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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. 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.
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At least 3-5 years' experience handling lost time workers compensation claims required; past experience with Virginia and Maryland jurisdiction is required. As a member of our claims team, utilize your knowledge of Workers Compensation to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes.
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PRIMARY 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.
$55,430 - $99,774 a yearFull-timeExpandApply NowActive JobUpdated 4 days ago - UpvoteDownvoteShare Job
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Litigation and Subrogation experience highly desired. WHAT WE ARE SEEKING We have assignments available to help our insurance carrier or Third-Party Administrator (TPA) clients in Property & Casualty (P&C) Commercial Claims Adjuster or Examiner positions.
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Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate.
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Aggressively pursue subrogation from culpable third parties, contributions on multiple defendant cases, and apportionment when there is pre-existing disability. Litigation management - Direct, manage, and control the litigation process.
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Handles claims and other functional work involving one or more lines of business other than property (i.e. auto, workers compensation, premium audit, underwriting) may be required. Provides multi-line assistance in response to workforce management needs; including but not limited to claim handling for Auto, Workers Compensation, General Liability and other areas of the business as needed.
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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.
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P&C Commercial Claims Adjuster - Carrier or TPA - REMOTE Put your Insurance Experience to work - FROM HOME At Wahve, we value significant insurance experience and want to revolutionize the way people think about phasing into retirement by offering qualified candidates the opportunity to continue their career working from home.
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Initiate the referral to the SIU of cases with suspected fraud. Review all medical bills for appropriateness prior to referral to InterMed for payment and posting to the claim file. Review and approve all vocational rehabilitation plans.
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