Description
Finding an On-Site job that fits your lifestyle isn't always easy.
That's where Kelly comes in. We're seeking a Workers Compensation Lost Time Senior Claim Examiner to work at a premier client in Los Angeles CA 90071.
Pay rate and Shift
l Job Duration: 6+ Month (Temp to Hire)
l Shift: Monday – Friday; 8:00 am - 4:30 pm
Pay : $52.39/hr. on W2
Job Summary:
l Client is currently seeking a Workers' Compensation Lost Time Senior Claim Examiner for our West Coast/Pacific region.
l The successful applicant will be handling claims from California.
l The position will report and reside in our Los Angeles, CA.
Key Responsibilities:
l Reviews claim and policy information to provide background for investigation.
l Handles all aspects of workers' compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process.
l Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with insured, claimant and medical providers.
l Evaluates the facts gathered through the investigation to determine compensability of the claim.
l Informs insureds, claimants, and attorneys of claim denials when applicable.
l Prepares reports on investigation, settlements, denials of claims and evaluations of involved parties, etc.
l Timely administration of statutory medical and indemnity benefits throughout the life of the claim.
l Sets reserves within authority limits for medical, indemnity and expenses and recommends reserve changes to Team Leader throughout the life of the claim.
l Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them.
l Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered.
l Works with attorneys to manage hearings and litigation
l Controls and directs vendors, nurse case managers, telephonic cases managers and rehabilitation managers on medical management and return to work initiatives.
l Complies with customer service requests including Special Claims Handling procedures, file status notes and claim reviews.
l Files workers' compensation forms and electronic data with states to ensure compliance with statutory regulations.
l Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.
l Works with in-house Technical Assistants, Special Investigators, Nurse
l Consultants, Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service.
Qualifications and Experience:
l Experience utilizing strong communication and telephonic skills.
l Experience working in a customer focused, fast-paced, fluid environment
l Prior experience requiring a high level of organization, follow-up, and accountability
l Prior workers' compensation claim handling experience or other similar type of claim handling experience is required (healthcare, short-term / long-term disability, auto personal injury protection / medical injury, or general liability).
l Prior insurance, legal or corporate business experience is a plus but not required
l AIC, RMA, or CPCU completed coursework or designation(s) is a plus but not required
l Proficiency with Microsoft Office Products
l Knowledge of medical terminology is required
l Knowledge of bill processing is required
l Certification to handle CA Workers Compensation claims is required
l Experience handling claims in the states of CO, UT, NV and AZ preferred
l If you do not already have one, you will be required to obtain an applicable resident or designated home state adjusters license and possibly additional state licensure.
What happens next:
Once you apply, you'll proceed to next steps if your skills and experience look like a good fit. But don't worry-even if this position doesn't work
out, you're still in our network. That means all of our recruiters will have access to your profile, expanding your opportunities even more.
Helping you discover what's next in your career is what we're all about, so let's get to work.
Apply to be an Workers Compensation Lost Time Senior Claim today!
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As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.
Get a complete career fit with Kelly®.
You're looking to keep your career moving onward and upward, and we're here to help you do just that. Our staffing experts connect you with top companies for opportunities where you can learn, grow, and thrive. Jobs that fit your skills and experience, and most importantly, fit right on your path of where you want to go in your career.About Kelly
Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.
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