Workers Compensation Claims Examiner

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🔥 43 minutes 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 developed by Ceridian. It delivers payroll, HR, workforce management (time and attendance, scheduling), benefits administration, and talent management as a single SaaS application designed for businesses and enterprise 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 plans; 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