Finding a job that fits your lifestyle isn’t always easy. That’s where Kelly® comes in. We’re seeking a Claims Examiner – Workers Compensation  to work remotely. Sound good? Take a closer look below. We’re here to help you find something great that works for you—so you won’t miss a moment of what really matters in your life.  

Pay Rate: $51.03 per hour

Why you should apply to be a Claims Examiner – Workers Compensation:

• Competitive pay rate.
  

• Opportunity to work with a reputable company.
  

• Convenient dayshift timing (M-F, 8am-5pm PST).
  

• Remote or on-site role.

What’s a typical day as a Claims Examiner – Workers Compensation ? You’ll be:

• Analyzes and processes complex or technically difficult workers’ compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
  

• Negotiates settlement of claims within designated authority.
  

• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
  

• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
  

• Prepares necessary state fillings within statutory limits.
  

• Manages the litigation process; ensures timely and cost effective claims resolution.
  

• Coordinates vendor referrals for additional investigation and/or litigation management.
  

• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
  

• Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
  

• Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
  

• Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
  

• Ensures claim files are properly documented and claims coding is correct.
  

• Refers cases as appropriate to supervisor and management.
  

• Performs other duties as assigned.
  

• Supports the organization’s quality program(s).
  

• Travels as required.

This job might be an outstanding fit if you:

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

• CA Adjuster License/Certification
  

• 3+ years of relevant experience
  

• Subject matter expert of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.
  

• Excellent oral and written communication, including presentation skills
  

• PC literate, including Microsoft Office products
  

• Analytical and interpretive skills
  

• Strong organizational skills
  

• Good interpersonal skills
  

• Excellent negotiation skills
  

• Ability to work in a team environment
  

• Ability to meet or exceed Service Expectations

What happens next Once you apply, you’ll proceed to next steps if your skills and experience look like a good fit. But don’t worry—even if this position doesn’t work out, you’re still in our network. That means all of our recruiters will have access to your profile, expanding your opportunities even more. Helping you discover what’s next in your career is what we’re all about, so let’s get to work. Apply to be a Claims Examiner – Workers Compensation today!
 

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