Fulltime Workers Compensation Claims III Job
Yoh - Encino, CA

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Yoh is actively seeking candidates for a full time contract position for a Workers Compensation Claims Examiner III to join our client in Encino, CA.

Must Have Experience

Job Overview:
Analyzes and processes complex or technically difficult workers compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution

Job Responsibilities:
  • Assesses liability and resolve claims within evaluation.
  • Negotiates settlement of claims up to designated authority level.
  • Calculates and assigns timely and appropriate reserves to claims; monitors reserve adequacy throughout the life of the claim.
  • Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles claims within designated authority level.
  • Prepares necessary state filings within statutory limits.
  • Manages the litigation process; ensures timely and cost effective claims resolution.
  • Coordinates vendor referrals for additional investigation and/or litigation management.
  • Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
  • Manages claim recoveries, including but not limited to subrogation, Second Injury Fund recoveries and Social Security offsets.
  • Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
  • Communicates claim activity and processing with the ill or injured party and the client; maintains professional client relationships.
  • Ensures claim files are properly documented and claims coding is correct.
Job Qualifications:
  • Baccalaureate degree from an accredited college or university preferred.
  • Licenses as required. Professional certification as applicable to line of business preferred.
  • Must have Four (4) years of claims management experience (required).
Skills and Knowledge:
  • In-depth knowledge of appropriate insurance principles and laws for line-of-business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security application procedures as applicable to line-of-business.
  • Excellent oral and written communication, including presentation skills.
  • PC literate, including Microsoft Office products.
  • Analytical and interpretive skills.
  • Strong organizational skills.
  • Excellent negotiating skills.
  • Good interpersonal skills.
  • Ability to work in a team environment.
Discover all that's possible with Yoh. Apply now.

Recruiter: Jennifer Yerkes

Yoh is a professional staffing provider with over 70 years of experience in the short- and long-term staffing services industry; visit our website to learn both about our company and about our leading staffing solutions .

Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V.



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Yoh Services, LLC - 21 months ago - save job - block
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Yoh Company is a unit of Yoh, one of the largest staffing services firms in the United States with more than 550 million USD in total...