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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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Utilizes the Nursing Process (assessment, diagnosis, planning, intervention and evaluation) to facilitate medical management to attain maximum medical improvement and return-to-work (RTW) per state jurisdictional requirements.
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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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Certificates and Licenses Active study for the IEA Certificate and Self-Insured Certificate, and successful completion of, or active study for the WCCP designation, or the equivalent in related studies or work experience.
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Independently handles all assigned claims up to and including most complex where Injured worker (IW) remains out of work and unlikely to return to position. The claim involves moderate to complex litigation issuesIW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality.
$65 - $108Full-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Litigation management - Direct, manage, and control the litigation process. 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.
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Workers Compensation Adjuster III Summary: Reports directly to the unit Claims Supervisor and may be called upon to provide technical backup in the absence of the Claims Supervisor. Team Work - Supports everyone's efforts to succeed.
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Minimum of five (5) years' experience handling workers compensation claims. Coordinates return to work (RTW) and sets target dates. Must be well versed in Minnesota, Pennsylvania, Indiana, Iowa and/or Missouri Workers Compensation statutes.
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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. Exhibit and maintain a courteous and helpful attitude and project a professional image on behalf of the company.
TemporaryRemoteExpandApply NowActive JobUpdated 10 days ago - UpvoteDownvoteShare Job
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Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments. 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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Communicates with internal managed care and medical resources to ensure coordination with medical providers, injured workers and employers in developing return to work strategies and treatment plans.
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Receive, review, and process reports of on-duty employee injuries, coordinate worker's compensation claims, arrange and authorize treatment of the employee by medical care providers; review and process medical bills and solve billing/payment problems with medical providers; process return-to-work and other documents and forms required by insurance carrier, TPA, and/or State of Michigan.
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Workers Compensation Specialist. 5 or more years experience with workers compensation claims management. Monitors medical and disability status to support communication with injured associates as needed to set realist goals for recovery and return to work.
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Job Description: Pay Range $47hr - $51hr 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.
$47 - $51 an hourExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Title: Claims Adjuster - Workers Compensation (Hourly) (1309922)- Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
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workers compensation complex return work jobs
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