Workers Compensation Claims Examiner

Alliant Insurance Services, Inc.

  • San Diego, CA
  • 11 days ago
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    Skills

    • Adjudicationunmatched
    • Analysis Skillsunmatched
    • Best Practicesunmatched
    • Brokerageunmatched
    • Claims Managementunmatched
    • Claims Processingunmatched
    • Communication Skillsunmatched
    • Compensation and Benefitsunmatched
    • Consultingunmatched
    • Customer Relationsunmatched
    • Customer Support/Serviceunmatched
    • Data Qualityunmatched
    • Documentationunmatched
    • Insuranceunmatched
    • Legalunmatched
    • Microsoft Officeunmatched
    • Microsoft Product Familyunmatched
    • Negotiation Skillsunmatched
    • People Managementunmatched
    • Performance Managementunmatched
    • Performance Reviewsunmatched
    • Presentation/Verbal Skillsunmatched
    • Project Planningunmatched
    • Quality Assuranceunmatched
    • Quality Managementunmatched
    • Risk Managementunmatched
    • Staff Requirementsunmatched
    • State Laws and Regulationsunmatched
    • Statutory Lawsunmatched
    • Subrogationunmatched
    • Time Managementunmatched
    • Vendor/Supplier Relationsunmatched
    • Worker's Compensationunmatched
    • Writing Skillsunmatched

    Description

    Alliant Insurance Services is one of the nation's largest and fastest-growing insurance brokerage and consulting firms. We operate through a network of specialized national platforms and local offices to offer our clients a comprehensive portfolio of solutions built on innovative thinking and personal service. Alliant is changing the way our clients approach risk management and benefits, so they can capitalize on new opportunities to grow and protect their organizations.

    More information is available on the companys website at: www.alliant.com.

    SUMMARY

    Responsible for reviewing, adjudicating and managing low- and mid-level workers compensation claims in accordance with company guidelines, statutory regulations and best practices. Manages claims through well-developed action plans to an appropriate and timely resolution.

    ESSENTIAL DUTIES AND RESPONSIBILITIES

    Reviews and evaluates workers' compensation claims to determines compensability and benefits due on indemnity claims;

    Sets and manages reserve accounts, ensures that accurate levels are maintained and that documentation is on file with state agency;

    Develops and manages workers' compensation claims action plans and manages to resolution;

    Establishes and manages return-to-work plan; Identifies modified work opportunities to enable return to work;

    Coordinates claim action and processing with claimant and client;

    Approves claim payments, manages subrogation of claims and negotiates settlements;

    Develops effective working relationships with outside vendors and ensures professional client relationships;

    Communicates with injured workers, employers, doctors and attorneys;

    Composes medical examination assignments, letters and legal orders;

    Maintains a quality assurance program to support the Total Performance Management initiative and the consistent delivery of quality claims;

    Complies with agency management system data standards and data integrity (enters and maintains complete and accurate information);

    Other duties as assigned.

    QUALIFICATIONS

    EDUCATION / EXPERIENCE

    Bachelors Degree in business or equivalent combination of education and experience

    Three (3) or more years of experience in workers' compensation field

    Certificates and/or licenses as required by State regulation

    SKILLS

    Excellent verbal and written communication skills

    Excellent presentation skills

    Excellent customer service skills

    Analytical skills with ability to interpret results

    Strong organizational skills

    Good interpersonal skills with ability to work in a team environment

    Proficient in Microsoft Office Products

    #LI-DR1

    We are proud to provide comprehensive, high quality employee programs to meet employees needs now and in the future, including a very competitive financial package. We encourage you to explore what we have to offer.

    For immediate consideration for this position, please click on the "Apply" button.

    Alliant Insurance Services, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment based on their qualifications and ability without regard to race, color, religion, sex (including pregnancy, childbirth, breastfeeding, sexual orientation, and gender identity), national origin, ancestry, physical or mental disability, medical condition, marital status, age, genetic information, or status as a protected veteran, in accordance with applicable federal, state, and local laws, including California law.

    Applicants are protected under Federal law from discrimination. If you need an accommodation to complete the application process or would like to review these materials in an alternative format, please reach out to Careers@Alliant.com

    For more information on Alliant Insurance Services benefits, please visit www.alliant.com/about/careers/benefits

    Numbers & Facts

    LocationSan Diego, CA

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