York Risk Services Senior Workers Compensation Claims Examiner in El Dorado Hills, California

Job Description

The Senior Workers Compensation Claims Examiner investigates claims to determine an injured worker’s entitlement to Workers’ Compensation benefits. He/she administers indemnity and medical benefits for valid Workers’ Compensation claims and manages a caseload of claims from inception to closing or settlement. He/she assists Unit Manager with mentoring new claims examiner and/or supervisory functions.

  • Completes 3-point contact on new claims within 24 hours in order to obtain information necessary to make a compensability decision on the claim
  • Establishes appropriate reserve levels based on financial exposure and updates reserves upon receipt of new information
  • Directs assistant to properly pay indemnity benefits payments and Awards. Issue state-mandated benefit notices within the required timeframes.
  • Annotates, categorizes and addresses incoming mail on a daily basis.
  • Responding to questions and requests from the client.

Required Skills

SKILLS/ABILITIES:

  • Ability to prioritize multiple tasks and meet deadlines
  • Excellent written and verbal skills
  • Excellent customer service skills

KNOWLEDGE:

  • Workers’ Compensation law; policies and procedures
  • Medical and legal terminology, Integration with Medicare Required Experience

EDUCATION:

  • BS / BA or Equivalent Work Experience

EXPERIENCE:

  • 5 to 8 years

Tracking Code: ELDORADOHILLS09291701

Job Location: El Dorado Hills, California, United States

Position Type: Full-Time/Regular