Claims Representative - Workers Compensation (On-Site - Rancho Cucamonga)

PRIMARY PURPOSE:

To process low 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 with general supervision.

• Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
• Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

• Supports the organization's quality program(s).
• Travels as required.

QUALIFICATIONS:

• Education & Licensing: Bachelor's degree from an accredited college or university preferred.
• Experience: Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.