Workers' Compensation Resolution Specialist II
$26.44 - $33.17 per hourGemini Duplication
Company Introduction If you are seeking meaningful work in a company that values integrity, innovation, and growth, consider a career with Gemini Legal. Headquartered in Rocklin, California, Gemini Legal is an industry‑leading legal support company serving attorneys across California. Our proprietary, in‑house developed technology platform powers efficient, secure digital record collection and workflow management. In addition to records services, we provide vocational counseling to injured workers, delivering comprehensive support throughout the life of a case. Our growth is powered by our people. We operate with an open‑door leadership philosophy and a culture built on accountability, collaboration, and service. We promote from within whenever possible and invest in individuals who demonstrate commitment and potential, including those new to the industry. Ethical. Passionate. Smart. These principles guide how we work, how we serve clients, and how we support one another. Employees of Gemini Legal Support may be exposed to confidential, private or sensitive information, protected under HIPAA. About the Role The Workers' Compensation (WC) Resolution Specialist II’s primary responsibility is to manage and resolve accounts/cases associated with workers' compensation claims in outstanding AR greater than 1 year. This role demands a strong understanding of workers' compensation regulations, excellent negotiation skills, and the ability to collaborate with multiple stakeholders. An additional objective is analyzing and preparing cases for the possibility of litigation. This position includes compliance with HIPAA, state and federal document security regulations. Specialists receive advanced training in workers’ compensation laws, regulations, and copy service fee schedules related to all aspects of billing, collections, objections, and the regulatory landscape specifically related to copy service fees. The WC Resolution Specialist II will also be involved in mentoring, training, and assisting other departments in the understanding of workers compensation as a whole and copy service as an individual area of specialty. Location: West Covina, CA or Rocklin, CA (Remote‑Hybrid) Schedule: Monday‑Friday, 8:00am‑5:00pm Compensation: $26.44‑$33.17 per hour Responsibilities Review, assess, and analyze cases associated with workers' compensation claims to determine their validity and accuracy Conduct comprehensive research and gather necessary documentation to support negotiations and resolutions Negotiate with claims adjusters, lien resolution specialists, defense attorneys, and other relevant parties to reach fair and reasonable settlements Ensure compliance with all relevant workers' compensation laws, regulations, and guidelines in lien resolution activities Maintain effective communication with various stakeholders, including claims adjusters, attorneys, lien units, clients, and internal stakeholders to update them on the progress of case resolution Maintain detailed records of all resolution activities, including agreements, payments, and any relevant correspondence Create and maintain detailed analysis of cases in preparation of litigation Record keeping of payments pursuant to settlement agreements and correspondence with a guarantee of payment Handle any disputes or conflicts related to lien resolution in a professional and diplomatic manner Identify opportunities to minimize costs associated with resolution of cases while upholding legal and ethical standards Stay updated on changes in workers' compensation laws and regulations, and attend training sessions or workshops as necessary May handle collections of the Voucher and/or Civil AR, requiring basic workers’ compensation knowledge related to vouchers Other duties as required Qualifications High School diploma or equivalent required 3+ years of experience in the workers’ compensation field required Typing speed of at least 35 WPM with 90% accuracy In depth understanding of workers' compensation statutes, regulations, and case law Ability to collaborate with multiple stakeholders Comprehensive skills in process writing and flow chart mapping Exceptional ability to effectively negotiate Excellent verbal and written communication skills, including proofreading, syntax, and grammar General computation skills, including the use of a calculator Proficient using a computer, business phone, office software, video conferencing, and other computer programs including Google Workplace and Microsoft applications Ability to complete data entry with a high level of accuracy Functional Requirements Sitting for at least one hour at a time (total: 4‑6 hours/day) Keyboarding for extended periods of time (total: 4‑6 hours/day) Using a phone with or without a headset for extended periods (total: 3‑5 hours/day) Benefits Comprehensive medical, dental, and vision coverage Generous paid time off, including PTO, sick leave, volunteer time, and paid holidays 401(k) plan with company match Tuition reimbursement program Employee Assistance Program and legal assistance benefit Company‑paid annual charitable donation in your name Employee recognition program Salary: $26.44‑$33.17 per hour. #J-18808-Ljbffr
$26.44 - $33.17 per hour
...services, we provide vocational counseling to injured workers, delivering comprehensive support throughout the life... ...HIPAA. ABOUT THE ROLE The Workers' Compensation (WC) Resolution Specialist II's primary responsibility is to manage and resolve accounts...SuggestedHourly payFull timeWork at officeRemote workMonday to Friday$95k - $110k
...Job Type Full-time Description Bender Insurance Solutions is seeking an experienced Workers' Compensation Specialist to serve as a strategic claims advocate for our commercial clients. This is not an adjuster role. This is a consultative position focused...SuggestedFull time$28 - $40 per hour
...AvonRisk is the nation’s leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers’ compensation, liability, managed care, and risk management across 32 states. With nearly 700 professionals and brands including Intercare...Suggested- ...Job Description Job Description Worker Compensation Claims Adjuster Workers' Compensation Claims Adjuster - Assist a Dynamic Team... ...productive team environment focused on excellence in claim resolution Our Offer: Competitive salary and benefits package...Suggested
$80k - $100k
## Workers Compensation Claims ExaminerBy joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do... ...well-developed action plans to an appropriate and timely resolution.* Negotiates settlement of claims within designated authority...SuggestedWork at officeRemote workFlexible hours$80k - $100k
Workers Compensation Claims Examiner - Sedgwick Join to apply for the Workers Compensation Claims Examiner role at Sedgwick . Direct message... ...well‑developed action plans to an appropriate and timely resolution. Negotiates settlement of claims within designated authority...Work at officeFlexible hours$80k - $100k
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...AvonRisk is the nation’s leading specialty risk manager for self-insured organizations, uniting respected regional leaders in workers’ compensation, liability, managed care, and risk management across 32 states. With nearly 700 professionals and brands including Intercare...$20 - $21 per hour
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Job Description We are seeking an experienced Workers’ Compensation Hearing Representative to join our California team. This in‑office position... ...Compensation benefits. Led by highly regarded civil rights specialist, Jason Turkish, Jessica Turkish, Melissa Nyman, and Spencer...Work at office- ## Workers Compensation Claims Team Lead | Roseville, CA or Long Beach, CA,Applylocations: Roseville, CA: Long Beach, CAtime type: Full timeposted on: Posted Yesterdayjob requisition id: R75045By joining Sedgwick, you'll be part of something truly meaningful. It’s what...Work at officeFlexible hours
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A leading insurance firm is seeking a Workers’ Compensation Specialist to act as a strategic claims advocate for commercial clients. The role requires 3+ years experience in workers' compensation claims, focusing on improving claim outcomes and influencing strategies while...- ...Sedgwick Claims Management Services Ltd is hiring a Workers Compensation Claims Examiner for their offices in Roseville, CA or Long Beach, CA. This role involves analyzing claims, negotiating settlements, and ensuring compliance with industry standards. Ideal candidates...Flexible hours
$80k - $100k
A nationwide claims management company is seeking a Workers Compensation Claims Examiner in California. The role involves analyzing complex workers' compensation claims, negotiating settlements, and managing litigation processes. Ideal candidates should possess a bachelor...Flexible hours$20 per hour
Workers Compensation Claims Assistant Location: Roseville, CA (On-Site) By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your...Work at officeFlexible hours- Policy Advocate - Labor, Employment, & Workers Compensation The California Chamber of Commerce has an opening for a lobbyist to represent the CalChamber viewpoint in the legislative and regulatory arena. The Policy Advocate will specialize in Labor, Employment, and Workers...Full timeLocal area
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...Job Description Job Description Workers’ Compensation Defense Attorney Direct Counsel is representing a reputable Defense Workers’ Compensation law firm seeking an Attorney to join its growing team. This position offers the flexibility to work remotely or...Temporary workWork at officeRemote work- ...Workers Compensation Associate Claims Adjuster Are you looking for an opportunity to join a fast-growing company that consistently outpaces... ...Claims Adjuster I or a Workers Compensation Claims Adjuster II. The salary range posted reflects the range for the varying pay...Work at officeLocal areaImmediate start
- AVONRISK in Rocklin is seeking an experienced Workers' Compensation Claims Adjuster to join our dynamic team. You will play a critical role... ...ideal candidate will have a commitment to excellence in claims resolution and teamwork in a supportive environment. #J-18808-Ljbffr...
- Golden 1 Credit Union is seeking a Member Service Specialist II in Citrus Heights, CA, to provide essential services to members, process transactions, and ensure great customer service. The ideal candidate will have a high school diploma and at least one year of experience...
- A healthcare organization in California is seeking a Prior Authorization Representative responsible for verifying prior authorization requirements and facilitating patient access to therapies. The role involves coordinating paperwork and communication with physician offices...Remote job
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...health services or meeting other Mental Health Rehabilitation Specialist qualifications. LICENSES; CERTIFICATES; SPECIAL... ...motorcycles. Schedule: Monday – Friday, 8:30 am - 5:00 pm Compensation: $25 to $27 Bilingual Spanish speakers encouraged to apply...Monday to Friday$100k - $115k
Sedgwick Claims Management Services Ltd is seeking a Claims Team Lead to oversee examiners handling workers compensation claims in Roseville, CA. This hybrid role requires expertise in California workers compensation claims and supervisory experience. The ideal candidate...- Sedgwick Claims Management Services Ltd is seeking a Workers Compensation Claims Team Lead for their hybrid locations in Roseville or Long Beach, CA. This role oversees multiple teams handling claims, providing guidance and ensuring quality standards. Ideal candidates...Flexible hours
$80k - $98k
Sedgwick Claims Management Services Ltd is seeking a Workers Compensation Claims Examiner for their Roseville location. This role involves analyzing and processing workers' compensation claims and requires a minimum of 5 years of claims management experience, with knowledge...- ...not be applicable to other locations. At David’s Bridal, it is rare for an individual to be hired at the high end of the range in their role, and compensation decisions are dependent upon the details and circumstances of each position and candidate. #J-18808-Ljbffr...Part time
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