Workers Compensation Claims Adjuster Temp-Perm

Los Angeles, CA - USA

Monthly Salary: Not Disclosed

Posted on: 10 hours ago

Vacancies: 1 Vacancy

Job Summary

About Charles Taylor

Charles Taylor is a leading international provider of professional claims and insurance services to clients around the world. Charles Taylor TPA is the fastest growing division within the Group administering variety of workers compensation and property and casualty claims.

We are seeking a Workers Compensation Claims Adjuster who lives in Orange or Los Angeles County to join our team. This is a temporary position that could become permanent for the right candidate.

Position Summary:

The Workers Compensation Claims Adjuster is responsible for managing all aspects of a workers compensation claim which includes determining compensability verifying coverage administering disability and medical benefits skillfully negotiating claim resolutions troubleshooting and assisting injured employees employers and medical/legal professionals with any service needs throughout the lifespan of a claim.

Essential Functions:

Receives newly reported claims
Maintains and updates claim notes throughout lifespan of claim
Records claim information in electronic database
Interviews claimants insureds medical professionals and witnesses to determine claim validity
Communicates claim compensability decisions to claimant employer and medical provider
Sets appropriate reserves based on nature/extent of injury
Calculates lost time wages makes disability payments directly to claimants and diaries future payments as appropriate
Orders independent medical examination as necessary and prepares all relevant documentation for physician review
Maintains regular correspondence with claimants insureds and nurse case manager to include claim updates medical appointments or issues with disability payments
Reviews and processes medical bills through third-party vendor for additional discount opportunities
Aggressively collaborates with claimants and insureds to ensure early return-to-work is pursued
Works in partnership with legal counsel to warrant that insureds interests are protected on litigated claims which includes providing all relevant claim documentation needed for defense counsel to successfully defend claim and evaluate ultimate claim exposure
Attends settlement conferences mediations and hearings on behalf of the insurance company/insured
Reviews and approves defense attorney bills within authority
Works with underwriting to help provide relevant information on losses for renewal rates as well as Risk Management to identify trends and may interact with agents for insureds on losses
Responds to State requests for health cost disputes applications for hearings and penalty assessment letters
Identifies subrogation potential and pursues recovery
Leads claim reviews with clients as requested
Other duties as assigned

Knowledge Skills and Abilities:

Bilingual in Spanish a plus
3 years of experience adjusting Workers Compensation Claims in California required
Proficiency in entire Microsoft Office suite
Knowledge of relevant workers compensation laws
Strong grasp of medical terminology
Familiarity with medical cases and how treatment typically progresses
Excellent oral and written communication abilities
Attention to detail and good organization skills
Ability to negotiate issues and settlements
Strong focus on customer service which includes timely response to requests/inquiries
Ability to adapt to changing technologies and learn functionality of new equipment and systems
Ability to establish and maintain effective working relationships with others

Charles Taylor offers a competitive salary commensurate with experience and excellent benefits including medical dental vision life insurance and 401(K) with match. If you are seeking a career where you can achieve great things for great clients in a supportive and collaborative environment then we may be the place for you.

Equal Opportunity Employer

Here at Charles Taylor we are proud to be an Inclusive Employer. We provide an environment of mutual respect with zero tolerance to discrimination of any kind regardless of age disability gender identity marital/ family status race religion sex or sexual orientation.

Our external partnerships and the dedicated work we do in promoting a transparent and fair recruitment and selection process all contribute to the successful inclusive and diverse culture and environment which we are proud to be a part of at Charles Taylor.

Values

Demonstrate and champion Charles Taylor Values by ensuring Agility Integrity Care and Accountability and Collaboration.

Required Experience:

Contract

About Charles TaylorCharles Taylor is a leading international provider of professional claims and insurance services to clients around the world. Charles Taylor TPA is the fastest growing division within the Group administering variety of workers compensation and property and casualty claims.We are ...