Claims Examiner Workers Compensation
Adecco US, Inc.
**(Remote) Workers' Comp Claims Examiner - $45/hour**
Temp-to-Hire | Benefits & 401k.
**Subject matter expert** of appropriate insurance principles and laws. Analyze complex claims, negotiate settlements, and drive cost-effective resolutions. Work remotely & enjoy competitive pay.
**Learn More & Apply Now!**
**Top reasons to work with Adecco.**
+ Payday every Friday
+ Upskilling opportunities through the Adecco Aspire Academy
+ An opportunity to get hired on permanent with our client.
+ Assigned your very own onboarding specialist.
**Job Details**
+ **Length of assignment: Temp to hire.**
+ **Location: Remote**
+ **Pay: $40 per hour.**
+ **Shift/Hours: Monday – Friday 8 AM – 4:30 PM**
**This is a fully Remote position.**
**Requirements**
+ Candidates must have a valid and current Workers' Compensation license or an All-Lines license.
+ Candidates must have a minimum of 3 years of experience handling workers' compensation claims specifically in the states of North Carolina (NC) and South Carolina (SC).
+ (5) years of claims management experience or equivalent combination of education and experience required.
+ Credit Check during onboarding process.
+ Microsoft Office products.
+ Travel as required.
+ Deep understanding of insurance principles and their application to workers' compensation claims.
+ Expertise in areas like recoveries, offsets, deductions, claim duration, and cost containment strategies.
**Job description**
+ 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.
**Pay Details:** $40.00 per hour
Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.
Equal Opportunity Employer/Veterans/Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.adecco.com/en-us/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
+ The California Fair Chance Act
+ Los Angeles City Fair Chance Ordinance
+ Los Angeles County Fair Chance Ordinance for Employers
+ San Francisco Fair Chance Ordinance
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