Workers' Comp Claim Representative II - CA

The job involves handling workers' compensation claims, determining compensability, and facilitating return to work for injured employees. It requires a bachelor's degree in a related field and relevant experience.

Requirements

• Verifies workers’ compensation coverage of employers and injured employees
• Determines compensability under workers’ compensation by thorough investigation of the claim
• Determines causal relationship between the reported injury and the incident to ensure appropriate payment of benefits
• Facilitates return to work for the injured employee
• Establishes timely and appropriate reserves based on the profile of the claim within given authority based on anticipated financial exposure
• Documents specifics of claims with potential for subrogation recovery, including amount of potential recovery monies
• Manages medical bills for non-indemnity and indemnity claims directly associated with the claimed injury
• Concludes and closes files following resolution of claims to meet internal performance standards while complying with state legislation to avoid penalties and manage expenses
• Negotiates settlements with attorneys or injured parties within given authority at the earliest possible point to bring cases to final disposition

Benefits

• Paid Time Off
• 401k Matching
• Retirement Plan