Claims Examiner- Workers' Compensation

Opportunity Number:
17637482
Company Name:
FirstComp
Location:
Ontario , CA US
Category:
Insurance

Updated: 7/10/2008
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Claims Examiner- Workers' Compensation
Company Overview:

As one of America’s fastest-growing companies, FirstComp is creating fresh career paths for people with energy, passion and exceptional talent. A national leader in the workers’ compensation industry, FirstComp is becoming a career destination, with rewarding positions and ever-emerging opportunities to grow and advance.

Named a Top 5 “Best Place to Work,” FirstComp flourishes through its “people-first” philosophy and has created an organic, dynamic culture where ideas flow freely and every team member collaborates to solve complex business challenges and reach new career heights.
Position Overview:
Exciting opportunity to work at a fast paced, challenging and growing workers' compensation insurance company.
Responsible for ensuring the proper administration, handling and resolution of all assigned claims.
Complete claim contacts and investigations, documenting and handling claim files within.
Handle full caseload of workers' compensation files including reserving, determine coverage and compensability, supervise legal defense and medical management, and bring claims to appropriate resolution.
Communicate the appropriate claim information to the assistant for support activity.
Field phone calls with highest-level customer service and best claim practices, attempt to handle all inquiries or action items on a claim in a timely manner.
Conclude the claim with appropriate resolution (RTW, settlement, termination of benefits, court order, etc.) Always have a plan in place for resolution and closure of the claim. Monitor plan and adjust as necessary during claim development and handling to bring them to closure.
Position Requirements:
Prior California adjusting experience is highly preferred.
Candidates must have knowledge of medical terminology, workers compensation laws, and benefits.
College degree or related certifications, some work experience preferable, medical records or insurance background helpful but not required. Similar background and transferable skills required.
Pleasant and professional telephone skills.
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