Claims Specialist, Workers Compensation

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $55.8k - $104.9k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

👩‍👩‍👧‍👦 Human Resources (HR)

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Crum & Forster

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1001 - 5000 employees

Crum & Forster (C&F) is a leading national property & casualty insurance company with a large, diversified specialty platform. We protect businesses and organizations from the unpredictable nature of risk, giving them the confidence to take on new challenges and flourish in today’s increasingly complex and uncertain world. C&F is client-focused, creative, and flexible in delivering customized products and services.

📋 Description

• Examines claims data and conducts investigations into routine and moderately complex claims • Adjusts and manages claims within the limit of assigned authority • Must be well versed in California Compensation statute claims • Receives lost time and complex medical only assignments • Verifies and determines applicability of coverage • Initiates 24-hour contact with employer, employee and 48-hour contact with attending physician • Handles catastrophic claims with supervisory oversight • Conducts telephone investigations as required • Evaluates and adjusts claims within the limits of authority • Consults with Claim Manager on claims requiring consultation • Makes assignments to nurse case management when indicated • Sets reserves for anticipated exposure up to authority limits • Completes mandatory Reserve Worksheets • Coordinates return to work (RTW) and sets target dates • Maintain diaries on maximum three (3) month intervals • Documents files in the claims system • Reviews medical bills for causal relationship and appropriateness of charges • Adheres to special account handling instructions • Attends account meetings by telephone and in-person • Manages litigation on the files

🎯 Requirements

• College degree, B.A. or equivalent experience • 3+ years experience handling workers compensation claims • Strong organizational skills • Good time management skills • Foreign language communications a plus • Excellent verbal and written communication skills • Strong aptitude and knowledge of Microsoft Office programs • Ability to quickly learn new programs. • Will abide by departmental policies and procedures

🏖️ Benefits

• Competitive compensation package • Generous 401K employer match • Employee Stock Purchase plan with employer matching • Generous Paid Time Off • Excellent benefits that go beyond health, dental & vision. • Programs focused on wellness, including physical, mental and financial wellbeing • Tuition reimbursement, industry-related certifications and professional training for career development • Dynamic, ambitious, fun, and exciting work environment • Matching donation program, volunteer opportunities, and corporate giving program