Claims Adjuster - Workers Compensation

BCForward is looking for Claims Adjuster - Workers Compensation- Remote

Position Title: Claims Adjuster - Workers Compensation
Location: Concord, CA office

Expected Duration: 03 months (Contract)
Pay Rate: $50.00/hr W2
Job Type: Full-Time (40 hours/week) | Contract | Onsite

Hiring Manager's Note:

• Work Location: Needs to be located in CA, hopefully close to our Concord, CA office.
• Experience: Need experienced examiner.
• Preferred Background: Sedgwick experience a plus.
• Certifications: SIP certificate a plus.
• Skills Required: Must have strong communication and customer service skills. Needs to be highly responsive to the supervisor, with the ability to keep diaries and mail current.

Workers Compensation Claims Examiner

Primary Purpose:
To analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements.

Essential Functions and Responsibilities:

• Manages workers compensation claims by determining compensability and benefits due on long-term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.
• Develops and manages workers compensation claims action plans through resolution.
• Coordinates return-to-work efforts and approves claim payments.
• Approves and processes assigned claims, determines benefits due, and manages the action plan pursuant to the claim or client contract.
• Manages subrogation of claims and negotiates settlements.
• Communicates claim action with claimant and client.
• Ensures claim files are properly documented and coded correctly.
• May handle complex lifetime or defined period medical claims, including state and physician filings and decisions on treatments recommended by utilization review.
• Maintains professional client relationships.

Additional Functions:

• Performs other duties as assigned.
• Supports the organization's quality programs.
• Occasional travel may be required.

Qualifications:

Education & Licensing:

• Bachelor's degree from an accredited college or university preferred.

Experience:

• Four (4) years of claims management experience or equivalent combination of education and experience required.

Skills & Knowledge:

• Strong understanding of regulations, offsets, deductions, disability duration, and medical management practices.
• Familiarity with Social Security and Medicare application procedures (as applicable).
• Excellent oral and written communication, including presentation skills.
• Proficiency with Microsoft Office and other PC tools.
• Strong analytical and interpretive abilities.
• Excellent organizational and negotiation skills.
• Strong interpersonal and teamwork capabilities.
• Ability to meet or exceed service expectations.

Benefits
BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

About BCforward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.

BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.

BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.

To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.

Interested candidates please send resume in Word format Please reference job code 237746 when responding to this ad.