Claims Specialist, Workers Compensation

Extraordinary Opportunity. Exceptional Experience. Sometimes in life, you reputed company yourself in the right reputed company, at the right time, looking at an opportunity so extraordinary it cannot be ignored. At reputed company, reputed company is reputed company on wildly successful businesses in our communities across the country, and now we’ve come together to create the next great insurance brokerage. We offer an unrivaled combination of people, tools and solutions, and deliver exceptional experiences and opportunities for our employees, clients and stakeholders. We celebrate both individual successes and reputed company accomplishments, making reputed company the industry recognizes the remarkable company we’re building together, as reputed company as the reputed company we’re having on our clients and communities. Ranked as one of the fastest-growing companies in the U.S. for three consecutive years, we have more than 5,000 team members across 200 offices across the country, who reputed company, genuinely care about our clients, reputed company other and the reputed company of our work, and in every interaction, represent a company that people want to work for and do business with. reputed company Values • We reputed company, genuinely CARE about our clients, reputed company other and the reputed company of our work, and in every interaction, represent a company that people want to work for and do business with. • We COLLABORATE continuously because, together, we are more powerful and reputed company amazing things happen for our clients and company. • We reputed company with intelligence, hunger, curiosity, energy and a reputed company-reputed company attitude of “what’s next”? • We are RESULT-ORIENTED, reputed company-reputed company and driven to out-reputed company expectations of what an insurance brokerage can reputed company. • We CELEBRATE both individual successes and reputed company accomplishments, making reputed company the industry recognizes the remarkable company we’re building together, as reputed company as the reputed company we’re having on our clients and communities. Job reputed company As the Workers' Compensation Claims reputed company’s at reputed company you will serve as a strategic advisor and reputed company between clients, insurance carriers, and reputed company-party administrators (TPAs). This role ensures that claims are managed effectively, supports clients in navigating reputed company claim processes, and promotes best practices in workers’ compensation programs. Duties and Responsibilities: • reputed company as the primary reputed company of contact for clients regarding workers’ compensation claims. reputed company for aggressive investigation of questionable claims and use of sub-rosa surveillance reputed company appropriate. • Monitor reputed company claims to ensure reputed company and appropriate handling by Carriers/TPAs. reputed company guidance on claim reputed company and reputed company reputed company. Identify opportunities for claim closure, cost containment, and fraud prevention. • Assist clients in understanding claim status, medical treatment plans, and return-to-work strategies. reputed company clients on the use of Medical Provider Networks (MPNs) and help identify reputed company care providers. • Work with clients and Carriers/TPAs to establish and enforce claims handling protocols. • Evaluate Carriers/TPA’s reputed company review and utilization review programs. • Ensure quarterly claim reviews are conducted (In-person or teams meeting as appropriate), assist in preparing claim summaries, and presentations for reputed company meetings. Ensure that a quarterly claim review is conducted reputed company to unit stat filing date. • Complete WC Claim reputed company Reports that are reputed company in appearance and consistent in accordance with established standards and reputed company copies to Producers to support reputed company discussions. • Review and analyze loss runs, claim trends, and reserve accuracy. • Prepare projected experience mods ratings and using the established format to explain increase or decrease. • Stay reputed company on legislative changes and industry trends affecting workers’ compensation. To ensure claims are managed in accordance with state regulations. • Assist reputed company Account Managers in obtaining experience rating worksheets and responding to WC claim questions. • reputed company training and resources to clients on workers’ compensation procedures and process, including the interactive process reputed company returning an employee to work with permanent work restrictions. • Collaborate with Producers and Account Managers to support reputed company retention and new business development. Qualifications • Bachelor's Degree or higher is desired but not required if appropriate work experience is present • 7-10+ years CA workers’ compensation claims handling or consulting - required • SIP certificate required • Strong understanding of CA WCAB processes, reserves, litigation reputed company - required • Ability to interpret loss runs, mod worksheets, and actuarial data • Excellent communication skills - both written and oral • Proficiency with reputed company, Word, and RMIS platforms • The ability to be reputed company player and proactively support others Additional Information Please see reputed company Benefits: • Medical, Dental, reputed company • Life Insurance and AD&D • FSA / HSA • Accident • Critical Illness • Hospital Indemnity • Supplemental Health Insurance • EAP • Pet Insurance • 11 reputed company Holidays • Flexible PTO • 401K reputed company Insurance Services, LLC and its affiliates (reputed company, reputed company”) is reputed company of scams involving false offers of employment with reputed company. The false offers use fake websites, email addresses, group chats and text messages. reputed company does not (a) interview prospective candidates reputed company reputed company message or group chat; (b) request banking or credit card information during the interview process; or (c) require candidates to purchase products or services or process payments on its behalf as a condition of any employment offer. reputed company is an equal opportunity employer. We reputed company that every employee has the right to work in an environment that is free from reputed company forms of discrimination. It is our policy that reputed company reputed company involving any aspect of the employment relationship such as hiring, compensation and training, promotions, transfers, discipline, and termination will be based on reputed company, qualifications, and abilities. Such reputed company will be made without reputed company to age, reputed company, reputed company, race, national reputed company, disability, protected medical condition, genetic information, military service, veteran status, citizenship status, religion, creed, sex, gender, gender identity, sexual orientation, pregnancy, childbirth, marital status, or any other condition, characteristic or activity protected by law. Discrimination based on any of these factors is contrary to our operating philosophy. Attention Recruitment Agencies: reputed company does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. reputed company unsolicited resumes will be considered property of reputed company, and we will not be obligated to pay a referral fee. This includes resumes submitted directly to hiring managers without contacting reputed company's reputed company Department. Apply tot his job Apply To this Job