Job Openings in Sacramento County and Beyond

Workers Compensation Claims Administrator

Sacramento, CA | Temporary Position

Post Date: 08/31/2017 Job ID: 38702.1 Industry: Healthcare/Medical
We are recruiting for a Workers Compensation Claims Administrator for a leading healthcare organization in Sacramento. The Claims Administrator will manage workers' compensation claims from time reported until resolution. This is a long term, contract opportunity; Monday-Friday.

Responsibilities: Manages the full scope of each assigned workers' compensation indemnity claim from the initial report to closure in a cost-effective manner and in compliance with the clients' requirements and quality standards. Assures and directs appropriate medical care and litigation management. Assures accurate and timely maintenance of reserving and excess reporting. Reviews and approves any and all compensation benefits in a timely fashion in compliance with current regulations. Facilitates return to work including modified duty. Manages ongoing causation issues. Arranges the appropriate medical evaluations to determine benefit entitlement. Negotiates claim resolution via Workers' Compensation AppealsBoard Award or administrative closure. Makes decisions in response to Requests for Authorization. Approves medical bills and prescriptions timely. Directs and controls medical care within the parameters of the workers' compensation laws to ensure the quality of care and facilitate return to work. Identifies and investigates third-party negligence and pursues subrogation where appropriate. Partners with defense counsel and employer in thediscovery, negotiation and resolution of litigated cases. Partners with in-house legal to manage multi-forum cases.

Requirements: Required: a minimum 2 years of experience involving compensation claims adjusting experience. High School Diploma required. College degree preferred. Possess critical thinking skills. Strong problem analysis, litigation management and organization skills. High attention to detail. Knowledge of basic medical and legal terminology. Strong oral and written communication skills. Proficient with Microsoft Office.

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