Claim examiner • concord ca
Workers' Compensation Examiner - CA (Contract - Full Remote).Workers' Compensation Examiner - CA (Contract - Full Remote) Pay Range $50.The Senior Claims Examiner will adjust workers' compensation ... Show more
Building Inspectors to join our growing company and serve our clients.The successful candidates must possess the ability to work independently, communicate effectively and maintain professional wor... Show more
Associate Claim Rep, Workers Compensation.Taking care of our customers, our communities and each other.By honoring this commitment, we have maintained our reputation as one of the best property cas... Show more
Taking care of our customers, our communities and each other.By honoring this commitment, we have maintained our reputation as one of the best property casualty insurers in the industry for over 17... Show more
The Claims Examiner is responsible for reviewing, processing, and adjudicating complex employee benefit claims with accuracy, timeliness, and regulatory compliance.This role requires deep experienc... Show more
Workers' Compensation Claims Adjuster.Are you searching for a unique opportunity that offers exceptional training and career growth with a dynamic and growing organization? Are you a Spanish speake... Show more
Psychiatrist** Mercor is seeking board-certified psychiatrists for a project with one of the world's top AI labs.We welcome applications from psychiatrists across all practice settings, with partic... Show more
About the Role** We're looking for professionals with deep, hands-on experience in the administrative and operational work that keeps healthcare organizations running — the "back office" of a medic... Show more
Alliant Insurance Services Job Opportunity.Alliant Insurance Services is one of the nation's largest and fastest-growing insurance brokerage and consulting firms.We operate through a network of spe... Show more
Work directly with Client Service Team (Client Managers, Client Executives and Principals) to provide a high level of client support in response to routine client requests and needs, act as liaison... Show more
Claims Examiner III - Hybrid / Remote.Hybrid Concord Office - Concord, CA 94520.Salary/year Level Experienced Position Type Full Time Job Shift Day Education Level High School Diploma or GED Trave... Show more
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By joining Sedgwick, you'll be part of something truly meaningful.It's what our 33,000 colleagues do every day for people around the world who are facing the unexpected.We invite you to grow your c... Show more
Workers' Compensation Claim Specialist.Location: Concord, CA (reporting remotely) Schedule: 8:00am-4:30pm Salary Range: $85,000 - $98,000 (depending on experience).Build Your Career With Purpose at... Show more
Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems.We are seeking experienced Coding Managers and HIM Coding leaders to evaluate AI-powered c... Show more
You have a clear vision of where your career can go.And we have the leadership to help you get there.At CNA, we strive to create a culture in which people know they matter and are part of something... Show more
Workers' Compensation Examiner - CA (Contract - Full Remote).The Senior Claims Examiner will adjust workers’ compensation claims from inception through settlement and closure, ensuring timely ... Show more
Senior Claims Specialist Commercial Auto BI.Investigate, evaluate and settle more complex first and third party commercial insurance auto claims.Evaluates each claim in light of facts; affirm or d... Show more
Under the direction of the Branch Manager or Field Leader, the Mobile Examiner's primary responsibility is to provide coverage in the field ensuring that mobile exams are completed accurately and o... Show more
Mercor is working with a leading AI research lab to improve the capabilities of next-generation AI systems.We are seeking experienced A/R Follow-Up Managers to evaluate AI tools designed to automat... Show more
The average salary range is between $ 40,387 and $ 91,289 year , with the average salary hovering around $ 56,396 year .
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Sr. Workers' Compensation Examiner - CA (Contract - Full Remote) Pay Range $50.25 - $55.89 based on experience, skills, and location The Senior Claims Examiner will adjust workers' compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing, and directing medical treatment, setting reserves, and negotiating settlements.
Establish contact with employer to review issues Respond to inquiries from the employer, employee, doctors, and attorneys Establish and maintain appropriate reserves Review legal correspondence and medical reports Evaluate and approve medical procedures and treatment Administer benefits and ensure appropriateness of all payments Investigate coverage, liability, and monetary value of claim Review medical and legal bills for appropriateness Discuss appropriateness of medical treatment with medical case manager Determine compensability Monitor and assist litigation Negotiate settlement of claim, liens, rehabilitation plans, etc. Prepare and present reports to clients Appropriately close claims Help resolve client billing and payment inquiries Investigate complaints from injured workers Document and code the claim files and claims system with all relevant information Maintain and update action plans within specified time frames Provide direction to Claims Assistants and Claims Technicians and assist with training, coaching, and mentoring as needed for them to support daily claims tasks Contact with employers, employees, attorneys, doctors, vendors, and other parties Provide customer service and support to clients and claimants Work collaboratively with attorneys to draft settlements and assist with litigation strategies Negotiate settlements Authorize and negotiate cost of medical treatment and supplies Internal communication with staff Prepare professional, well written correspondence and other communications
High School Diploma or equivalent (GED) required for all positions AA/AS or BA/BS preferred but not required Administrators Certificate from Self-Insurance Plans will be required within one year of employment if not already obtained Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f) 5+ years recent workers compensation CA Indemnity/Lost Time claims handling experience required Must have ED code experience Solid knowledge of workers compensation laws, policies, and procedures' Completion of IEA or equivalent courses Proficiency in determining case value and negotiating settlements Understanding of medical and legal terminology Mathematical calculating skills Well-developed verbal and written communication skills with strong attention to detail Excellent organizational skills and ability to multi-task Ability to type quickly, accurately and for prolonged periods Proficient in Microsoft Office Suite Ability to learn additional computer programs Reasoning ability, including problem-solving and analytical skills, i.e., proven ability to research and analyze facts, identify issues, and make appropriate recommendations and solutions for resolution
