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Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments. Ability to work in a team environment Ability to meet or exceed Service Expectations.
$43 - $48 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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We are currently seeking a highly experienced and detail-oriented Workers Compensation Claims Adjuster III. In this role, you will be responsible for managing a portfolio of complex workers' compensation claims from inception to resolution.
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The claim involves moderate to complex litigation issues IW has returned to work, reached Maximum Medical Improvement (MMI), and has PPD. File litigated to dispute the permanency rating and/or causality.
$63 - $105Full-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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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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Perform workers' compensation, return-to-work and related programs case management duties; provide information to employees regarding workers; compensation benefits; conduct accident investigations of reported employee and student injuries.
$25.63 an hourTemporaryExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Independently handles assigned claims of low to moderate complexity where Wage loss and the expectation is a return to work to modified or full duty or obtain MMI with no RTW. There are no litigated issues or minor to moderate litigated issues.
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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.
TemporaryRemoteExpandApply NowActive JobUpdated 28 days ago - UpvoteDownvoteShare Job
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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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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. Initiate the referral to the SIU of cases with suspected fraud.
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Review all medical bills for appropriateness prior to referral to InterMed for payment and posting to the claim file. 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.
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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.
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Assure that all assigned indemnity claims have an up to date plan of action outlining activities and actions anticipated for ultimately resolving the claim. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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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.
TemporaryRemoteExpandApply NowActive JobUpdated 28 days ago - UpvoteDownvoteShare Job
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Work in collaboration with specialty resources (i.e. medical and legal) to proactively pursue claim resolution opportunities, (i.e. return to work, structured settlement, and discontinuation of benefits through litigation.
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Coordinates case management with the Company's workers' compensation and disability vendor to monitor claim processing and support the employee's return to work. COMMUNICATION SKILLS:Requires the ability to communicate with internal and/or external customers in order to obtain and/or provide explanations and/or information on technical or other complex concepts to individuals with little or no background in the area under discussion.
Full-timeExpandApply NowActive JobUpdated Today
workers complex return to work jobs
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