Claims Professional

Claims Specialist

We are looking for a dedicated Claims Specialist to join our team in Los Angeles, California. This contract-to-permanent position offers an exciting opportunity to contribute to effective claims management processes within the service industry. The ideal candidate will bring expertise in workers' compensation and a proactive approach to managing medical records, claims data, and communication with stakeholders.

Responsibilities :

• Oversee the management of medical records related to workplace injuries, ensuring timely submission to insurance adjusters.
• Input medical details from records into the system and provide updates on diagnoses and work status to supervisors.
• Support injured employees and managers in implementing early return-to-work programs.
• Schedule and monitor follow-up doctor appointments, ensuring medical statuses are documented within 24 hours of visits.
• Communicate appointment outcomes to adjusters and supervisors promptly, maintaining a 24-hour response time.
• Track and update lost time and modified work statuses in the system regularly.
• Maintain consistent communication with insurance adjusters every 60 days until claims are resolved.
• Conduct audits of claim data and other relevant records to ensure accuracy and compliance.
• Monitor and review organizational claim-related data on a monthly basis.

Requirements :

Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training.