Workers Compensation Claims Adjuster II

Responsibilities Reports directly to the unit Claims Supervisor Responsible for effectively managing to conclusion an assigned inventory of claim files Perform a three-point contact on all new losses within 24 hours of receipt of the claim Thoroughly and accurately gather evidence regarding ongoing case facts Assure that all assigned indemnity claims have an up to date plan of action Form a partnership with the medical case manager to maximize early return to work potential Initiate the referral to the SIU of cases with suspected fraud Aggressively pursue subrogation from culpable third parties Assure that the claim file is handled in accordance with applicable statutes Review and approve all vocational rehabilitation plans Establish, monitor, and adjust monetary case reserves when warranted Review all medical bills for appropriateness prior to referral for payment Exhibit and maintain a courteous and helpful attitude Respond to telephone messages and inquiries within 24 hours Requirements Bachelor’s degree (B. A.) or equivalent from four-year college 3-5 years related experience & training 5 years without a SIP certificate Equivalent combination of education and experience Requires a working knowledge of the Labor Code of the State of California as it pertains to workers compensation claims Certifications & Qualifications Bachelor's Degree SIP Certificate #J-18808-Ljbffr Jobtailor