Immediate Hire! Liability Claims Adjuster

Berkshire Hathaway Homestate Companies has an immediate opportunity for an experienced workers compensation adjuster. This Claims Professional is responsible for the management of a caseload of workers compensation indemnity claims from inception to resolution, performing initial investigation and compensability determination, reserve analysis and strategic planning, timely benefit administration to injured workers, and coordination of medical care and legal process, while maintaining the highest level of service to our insureds.

Conducts the investigation of reported claims via three-point contact calls to determine coverage, compensability and severity, and to gather all other relevant information, documenting all relevant information thoroughly and escalating the investigation for further investigation when appropriate.
Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines.
Develops and updates a Plan of Action for the successful resolution of each claim; Makes prompt, sound decisions on issues that arise in claims based on the best information available, ensuring that work is performed in accordance with Company standards, training, supervisory direction, and applicable laws. Ensures that the actions of all other professionals involved in claim, including attorneys, nurse case managers, and investigators, are coordinated to achieve a successful resolution of the claim.
Assigns appropriate tasks to a Claims Assistant and/or Claims Clerical Assistant and ensures they are performed correctly and efficiently.
Accurately and thoroughly prepares litigation referrals, AOE/COE investigation referrals, and MSA referrals for submission to vendor; Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates settlement of claims.
Fosters a positive and close working relationship with partner company staff, including the Call Center, Medical Management, Special Investigations, Client Services, Underwriting, and Claims Legal.
Communicates effectively with individuals outside the company, including clients, medical providers, and injured workers.
Collaborates with Adjusting staff and relevant interdepartmental personnel on special projects focused on process efficiency.
Minimum of a High School diploma required or equivalent certificate required; Bachelor's degree from four-year College or university preferred.
Designated as a Claims Adjuster or Experienced Claims Adjuster per the California Code of Regulations and has completed the minimum required continuing education credits to adjust workers compensation claims for the State of California; Minimum of three years of indemnity adjusting experience managing large and/or complex claims and accounts within a workers' compensation carrier required
Maintains qualifying educational criteria to adjust workers' compensation claims for the State of California; agile learner with adaptive, smart time management skills.
To perform this job successfully, an individual should be proficient in the Microsoft Office Suite of applications (highly proficient in Excel preferred), and be proficient on applicable databases, systems and vendor software programs.
Work From Home Program (up to 2 days per week)
Reasonable caseload with in-house Medical Management support (UR, Med Bill Review, Resource Nurses); In-house Claims Assistant support
Free On-Site Fitness Facility
Free On-Site Garage Parking
Paid Holidays
Retirements Savings Match
Group Health Insurance (Medical, Dental, and Vision)
Life and AD&D Insurance
Long Term Disability Insurance
Accident and Critical Illness Insurance
Flexible Savings Accounts
Paid Community Volunteer Day
Employee Assistance Program
Tuition Reimbursement Program
Diversity, Equity and Inclusion Program

$