Workers Compensation Claims Examiner

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🔥 4 hours ago

🏄 California, Colorado – Remote

🏄 California – Remote ⛰️ Colorado – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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Dayforce

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

👥 HR Tech

☁️ SaaS

🏢 Enterprise

💰 $1G Post-IPO Debt - Dayforce on 2024-03

HR Tech • SaaS • Enterprise

Dayforce is a cloud-based human capital management (HCM) platform offered by Ceridian. It integrates payroll, HR, benefits administration, talent management, workforce management (time and attendance, scheduling), and related workforce processes into a single SaaS application aimed at business customers.

📋 Description

• Responsible for reviewing, adjudicating and managing low- and mid-level workers' compensation claims in accordance with company guidelines, statutory regulations and best practices. • Manages claims through well-developed action plans to an appropriate and timely resolution. • Reviews and evaluates workers’ compensation claims to determine compensability and benefits due on indemnity claims; • Sets and manages reserve accounts, ensures that accurate levels are maintained and that documentation is on file with state agency; • Develops and manages workers’ compensation claims action plans and manages to resolution; • Establishes and manages return-to-work plan; Identifies modified work opportunities to enable return to work; • Coordinates claim action and processing with claimant and client; • Approves claim payments, manages subrogation of claims and negotiates settlements; • Develops effective working relationships with outside vendors and ensures professional client relationships; • Communicates with injured workers, employers, doctors and attorneys; • Composes medical examination assignments, letters and legal orders; • Maintains a quality assurance program to support the Total Performance Management initiative and the consistent delivery of quality claims; • Complies with agency management system data standards and data integrity (enters and maintains complete and accurate information); • Other duties as assigned.

🎯 Requirements

• Bachelor's Degree in business or equivalent combination of education and experience • Three (3) or more years of experience in workers’ compensation field • Certificates and/or licenses as required by State regulation • Excellent verbal and written communication skills • Excellent presentation skills • Excellent customer service skills • Analytical skills with ability to interpret results • Strong organizational skills • Good interpersonal skills with ability to work in a team environment • Proficient in Microsoft Office Products