Claims Examiner - Workers Compensation (HYBRID- West Hills, CA/3 Days Remote)

PRIMARY PURPOSE OF THE ROLE:

To analyze Workers Compensation claims on behalf of our valued clients to determine benefits due, while ensuring ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.

• May Include
• Analyzing and processing claims through well-developed action plans to an appropriate and timely resolution by investigating and gathering information to determine the exposure on the claim.
• Negotiating settlement of claims within designated authority.
• Communicating claim activity and processing with the claimant and the client.
• Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.

Qualifications

• Education & Licensing:
• 5 years of claims management experience or equivalent combination of education and experience required.
• A High School Diploma or GED required.
• A Bachelor's degree from an accredited college or university preferred.
• A Professional certification as applicable to line of business preferred.
• Licensing / Jurisdiction Knowledge:
• SIP required or must be obtained within one (1) year of employment;
• California workers compensation jurisdictional knowledge required.

Essential Responsibilities

May Include

• Clear and conceptual thinking ability;
• Excellent judgment, troubleshooting, problem solving, analysis, and discretion;
• Ability to handle work-related stress;
• Ability to handle multiple priorities simultaneously;
• Ability to meet deadlines;

Mental:

• Computer keyboarding;
• Auditory/Visual:
• Hearing, vision and talking;

Taking Care of You

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

Work Environment Requirements

• When applicable and appropriate, consideration will be given to reasonable accommodations.

ARE YOU AN IDEAL CANDIDATE?

We are looking for driven individuals that embody our caring counts model and core values that include empathy, accountability, collaboration, growth, and inclusion.

OFFICE LOCATIONS

• West Hills, CA (Agile)
• 3 days remote

COMPENSATION

Actual compensation is influenced by a wide range of factors including but not limited to skill set, level of experience, and cost of specific location.

For the jurisdiction noted in this job posting only, the range of starting pay for this role is $80,000 - $90,000.

BENEFITS

• A comprehensive benefits package is offered including but not limited to, medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

QUALIFICATIONS

• Education & Licensing:
• 5 years of claims management experience or equivalent combination of education and experience required.
• A High School Diploma or GED required.
• A Bachelor's degree from an accredited college or university preferred.
• A Professional certification as applicable to line of business preferred.
• Licensing / Jurisdiction Knowledge:
• SIP required or must be obtained within one (1) year of employment;
• California workers compensation jurisdictional knowledge required.

ESSENTIAL RESPONSIBILITIES

• Clear and conceptual thinking ability;
• Excellent judgment, troubleshooting, problem solving, analysis, and discretion;
• Ability to handle work-related stress;
• Ability to handle multiple priorities simultaneously;
• Ability to meet deadlines;

TAKING CARE OF YOU

• Flexible work schedule.
• Referral incentive program.
• Career development and promotional growth opportunities.
• A diverse and comprehensive benefits offering including medical, dental, vision, 401k and matching, PTO, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.