Workers Compensation Claims Examiner – Property & Casualty Insurance Sacramento County Office. Several Position Available The Senior Claims Examiner will adjust workers compensation claims from inception through settlement and closure, ensuring timely processing of claims and payment of benefits, managing and directing medical treatment, setting reserves, and negotiating settlements. Respond to inquiries from the employer, employee, doctors and attorneys. Establish and maintain appropriate reserves. Administer benefits and ensure appropriateness of all payments. Discuss appropriateness of medical treatment with medical case manager. Determine compensability. Negotiate settlement of claim, liens, rehabilitation plans, etc. Prepare and present reports to clients. Document and code the claim files and claims system with all relevant information. Maintain and update action plans within specified time frames. Negotiate settlements. AA/AS or BA/BS preferred but not required. Administrators Certificate from Self-Insurance Plans will be required within one year of employment if not already obtained. Must possess a current Experienced Indemnity Claims Adjuster Designation, provided by an insurer, as defined in California Code of Regulations, Title 10, Chapter 5, Subchapter 3, Section 2592.01(f). 3 years recent workers compensation claims handling experience required. At least 5 years of workers compensation claims experience preferred. Solid knowledge of workers compensation laws, policies and procedures. Completion of IEA or equivalent courses. Proficient in Microsoft Office Suite. ClaimsXpress program experience preferred but not required. Proficiency in determining case value and negotiating settlements. Understanding of medical and legal terminology. Bilingual Spanish a plus SDL2017
Associated topics: bodily, claim, claimant, fraud, insurance, insurance examiner, investigate, investigation, liability adjuster, title examiner