Workers Compensation Claims Examiner II-Hybrid or Remote (CA) (40288)

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Flex Employee Services/IOS Staffing is here to support you along your journey. We are actively seeking talented individuals to fill the following opportunity. If this sounds like you (or someone you know), we’d love to connect!

About the Job

  • Title: Workers Compensation Claims Examiner II
  • Status: In Office Hybrid Or Open work remotely from home but must live in CA.-
  • Salary range: $93,600 - $104,000 Hourly-$45-$50
  • Referral bonus: $500

Summary

  • Needed by: Adjuster in the desk ASAP.
  • Type of client: Merchants building Maintenance
  • Effectively manages a caseload of 150 to 180 workers’ compensation files, including very complex claims.*
  • Initiates and conducts investigation in a timely manner.*
  • Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.*
  • Manages medical treatment and medical billing, authorizing as appropriate.*
  • Refers cases to outside defense counsel. Directs and manages as appropriate.*
  • Communicates with claimants, providers and vendors regarding claims issues.*
  • Computes and set reserves within Company guidelines. Limits are larger than those allowed for Claims Examiner I and Claims Examiner II.*
  • Settles and/or finalize all claims and obtains authority as designated.*
  • Maintains diary system for case review and documents file to reflect the status and work being performed on the file.*
  • Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns.*
  • Adheres to all Company policies and procedures.*
  • Conducts file reviews independently.*
  • Other duties as assigned.

Qualifications

  • Licenses: CA SIP
  • Experience: 5 + years of CA WC Claims experience

Ready to take the next step? Click "Interested" to kickstart your journey toward a rewarding career!

#IND1

Job Type: Full-time

Pay: $93,000.00 - $104,000.00 per year

Experience:

  • CA workers compensation claims handling: 5 years (Required)

License/Certification:

  • CA SIP (Required)

Work Location: Remote

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