Senior Claims Specialist (SIP)
New
J
JobgetherWorkers' Compensation
USFull-TimeSenior
Salary29.35 - 47.28 USD per hour
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Job Details
- Experience
- 4–5 years
- Required Skills
- Microsoft Excel
Requirements
- 4–5 years of California Workers’ Compensation claims handling experience required.
- Required California workers’ compensation adjuster license.
- Experience managing complex and high-value workers’ compensation claims.
- Experience with SIP claims handling required.
- Bachelor’s degree or equivalent combination of education and relevant professional experience.
- Strong understanding of claims administration, case management, and cost containment practices.
- Excellent written and verbal communication skills.
- Strong problem-solving abilities with the ability to analyze situations and make sound decisions.
- Proficiency with Microsoft Office tools, including Excel spreadsheets and related systems.
- Associates in Claims (AIC) or Associates in Risk Management (ARM) designation preferred.
Responsibilities
- Review new claims, verify coverage details, and acknowledge claims according to established procedures.
- Investigate claim validity, determine compensability, collect relevant information, and complete required documentation with applicable agencies.
- Establish claim reserves and authorize payments within assigned authority limits.
- Develop and manage detailed action plans with case managers and internal stakeholders to reduce claim costs and improve outcomes.
- Coordinate return-to-work strategies with appropriate parties to support successful claimant recovery.
- Manage subrogation activities, litigation processes, and potential recovery opportunities related to claims.
- Report claims to excess carriers when required and ensure appropriate claim handling procedures are followed.
- Maintain regular communication with clients, claimants, and stakeholders regarding claim status and resolution progress.
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