Workers Compensation Claims Adjuster – Senior

🔥 55 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $95k - $100k / year

⏰ Full Time

🟠 Senior

🔴 Lead

📋 Claims Specialist

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Intercare Holdings Insurance Services

WebsiteLinkedInAll Job Openings

201 - 500 employees

Insurance • Risk Management

Intercare Holdings Insurance Services is a privately held company that specializes in workers' compensation and liability claims administration, managed care services, and risk management solutions. Known for their client care and responsive service, Intercare integrates advanced technology and has an in-house Special Investigations Unit (SIU) to handle claims efficiently and reduce fraudulent activities. Their unique approach combines the depth and capacity of a large organization with the flexibility of a smaller firm, ensuring customized risk management and cost control solutions for clients. With a strong emphasis on customer satisfaction, Intercare is a trusted partner in reducing risk and maintaining fiscal stability for their clients.

📋 Description

• Reports directly to the unit Claims Supervisor • Effectively managing an assigned inventory of claim files • Perform a three-point contact on all new losses within 24 hours of receipt of the claim • Thoroughly and accurately document ongoing case facts and relevant information necessary for establishing compensability • Assure that all assigned indemnity claims have an up to date plan of action • Form a partnership with the medical case manager • Initiate the referral to the SIU of cases with suspected fraud • Aggressively pursue subrogation from culpable third parties • Review and approve all vocational rehabilitation plans • Establish, monitor, and adjust monetary case reserves • Review all medical bills for appropriateness prior to referral to InterMed

🎯 Requirements

• Bachelor's degree (B. A.) from four-year college or university • At least seven years related experience and/or training; or equivalent combination of education and experience • Requires a high degree of claims handling expertise including a minimum of at least five years experience managing indemnity cases, many with complex or high potential subrogation, rehabilitation, medical management, and/or legal issues • Possess an SIP certificate

🏖️ Benefits

• Comprehensive medical, dental, and vision benefits • Company contributions to HSA and FSA plans • Employer paid life and disability insurance • 401(k) with company match • Paid time off (PTO) and company paid holidays • Learning and development opportunities that support real career advancement • Employee assistance resources and a supportive culture that values balance and wellbeing