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Claims Specialist

Description

Ref ID: 00416-9502801202

Classification: Claims Administrator

Compensation: $18.00 to $22.00 hourly

Are you an experienced workers compensation claims professional that is looking for career growth and a chance to join a dynamic and growing company? Do you seek to join a team that produces exceptional work and meets the highest standards in a positive, supportive work environment?


Robert Half has an immediate opportunity for experienced workers compensation claims professionals in San Francisco, CA. Our client is dedicated to being the best workers compensation insurance company by providing compassionate care to injured workers, superior service to our customers and compelling opportunities for our employees. They have earned an enviable record of success and growth in the insurance industry while growing a culture centered around inclusion and collaboration. We pride ourselves on maintaining our small company feel and recognize that attracting and retaining high quality talent is essential to the success of our company.


As a Claims Professional, you will manage a caseload of Workers Compensation indemnity claims from inception to resolution. This position requires a self-starter who can work under a minimum of direction, achieve defined results and accept ownership for their work product.


Responsibilities:

•Conducts and directs the investigation of reported claims to determine coverage, compensability and severity and to gather all other relevant information, including making three-point contact telephone calls.

•Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines.

•Calculates and pays benefits in accordance with the law. Ensures that the claim as a whole is managed in accordance with all legal requirements including the issuance of appropriate notices and filings.

•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.

•Ensures that the actions of all other professionals involved in managing a 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.

•Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates the settlement of claims.

•Reduces fraud through early identification and escalation.

•Communicates effectively with individuals outside the company, including clients, medical providers, and injured workers.

•Fosters a positive and close working relationship with other Company staff, including the call center, medical management, special investigations, legal, and nurse case management.

•Ensures continual education requirements are met.

•Performs special assignments and projects as assigned.


Requirements

•EDUCATION: Bachelor’s degree from an accredited college or university is preferred.

•EXPERIENCE: Minimum two years of claims adjusting experience at a workers’ compensation carrier required.




Accountemps, a Robert Half Company, matches skilled accounting and finance professionals with remote or on-site jobs on a temporary and temporary-to-hire basis. Our experienced staffing professionals can promote you to employers and advocate on your behalf. We provide access to top jobs, competitive compensation and benefits, and free online training. For more opportunities, get the Robert Half app and receive instant notifications when our AI matches your skills and experience with jobs.

When you work with us, you’re working with the best. Robert Half has been recognized as one of FORTUNE’s “Most Admired Companies” every year since 1998 and was named to Forbes’ inaugural list of America’s Best Temporary Staffing Firms.

Questions? Call your local office at 1.888.490.3195. Robert Half will consider qualified applicants with criminal histories in a manner consistent with the requirements of the San Francisco Fair Chance Ordinance. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to temporary professionals. Visit https://roberthalf.gobenefits.net/ for more information.

© 2020 Accountemps. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (www.roberthalf.com/terms-of-use).

Job Snapshot

Location US-CA-San Francisco
Employment Type Full-Time/Part-Time
Pay Type Year
Pay Rate N/A
Store Type Accounting, Finance, Professional Services
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Company Overview

Robert Half

Robert Half is America’s top staffing agency, dedicated to helping talented people like you find rewarding temporary and full-time jobs with today’s leading companies. Our staffing experts work closely with local hiring managers and use AI-powered matching technology to find opportunities that match your skills and professional goals. With decades of experience in placing accounting, finance, administrative, technology, creative, marketing and legal professionals, we’ll help ensure your next career move is a successful one. Learn More

Contact Information

US-CA-San Francisco
Recruiter
415- 391-1306
-
Snapshot
Robert Half
Company:
US-CA-San Francisco
Location:
Full-Time/Part-Time
Employment Type:
Year
Pay Type:
N/A
Pay Rate:
Accounting, Finance, Professional Services
Store Type:

Description

Ref ID: 00416-9502801202

Classification: Claims Administrator

Compensation: $18.00 to $22.00 hourly

Are you an experienced workers compensation claims professional that is looking for career growth and a chance to join a dynamic and growing company? Do you seek to join a team that produces exceptional work and meets the highest standards in a positive, supportive work environment?


Robert Half has an immediate opportunity for experienced workers compensation claims professionals in San Francisco, CA. Our client is dedicated to being the best workers compensation insurance company by providing compassionate care to injured workers, superior service to our customers and compelling opportunities for our employees. They have earned an enviable record of success and growth in the insurance industry while growing a culture centered around inclusion and collaboration. We pride ourselves on maintaining our small company feel and recognize that attracting and retaining high quality talent is essential to the success of our company.


As a Claims Professional, you will manage a caseload of Workers Compensation indemnity claims from inception to resolution. This position requires a self-starter who can work under a minimum of direction, achieve defined results and accept ownership for their work product.


Responsibilities:

•Conducts and directs the investigation of reported claims to determine coverage, compensability and severity and to gather all other relevant information, including making three-point contact telephone calls.

•Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines.

•Calculates and pays benefits in accordance with the law. Ensures that the claim as a whole is managed in accordance with all legal requirements including the issuance of appropriate notices and filings.

•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.

•Ensures that the actions of all other professionals involved in managing a 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.

•Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates the settlement of claims.

•Reduces fraud through early identification and escalation.

•Communicates effectively with individuals outside the company, including clients, medical providers, and injured workers.

•Fosters a positive and close working relationship with other Company staff, including the call center, medical management, special investigations, legal, and nurse case management.

•Ensures continual education requirements are met.

•Performs special assignments and projects as assigned.


Requirements

•EDUCATION: Bachelor’s degree from an accredited college or university is preferred.

•EXPERIENCE: Minimum two years of claims adjusting experience at a workers’ compensation carrier required.




Accountemps, a Robert Half Company, matches skilled accounting and finance professionals with remote or on-site jobs on a temporary and temporary-to-hire basis. Our experienced staffing professionals can promote you to employers and advocate on your behalf. We provide access to top jobs, competitive compensation and benefits, and free online training. For more opportunities, get the Robert Half app and receive instant notifications when our AI matches your skills and experience with jobs.

When you work with us, you’re working with the best. Robert Half has been recognized as one of FORTUNE’s “Most Admired Companies” every year since 1998 and was named to Forbes’ inaugural list of America’s Best Temporary Staffing Firms.

Questions? Call your local office at 1.888.490.3195. Robert Half will consider qualified applicants with criminal histories in a manner consistent with the requirements of the San Francisco Fair Chance Ordinance. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to temporary professionals. Visit https://roberthalf.gobenefits.net/ for more information.

© 2020 Accountemps. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (www.roberthalf.com/terms-of-use).

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