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Los Angeles,
CA
(Click company name to view employer profile and all available
positions.) |
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Career Field |
Claims
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| Insurance
Discipline |
All
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| Relocation
Assistance |
Not Available
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| Job
Duration |
Full Time |
| Salary
Offered |
$60,000 - $65,000/ year |
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The Claims Administrator will oversee, service, manage, and resolve existing and new claims. Responsibilities include:
• Oversight of workers compensation claims with the Company’s claims vendors, but also includes commercial general liability, business auto, property, and other claims as delegated
• Provide expertise and general claims support in reviewing, researching, investigating, negotiating, processing, and adjusting claims
• Assist, advise, and support the Company’s Affiliates and business units in resolving claims issues
• Work closely with the Legal Department in assisting with various claims issues
• Work closely with our Affiliates’ Human Resources Departments in assisting with, and the establishment of, proper claims reporting policies and procedures, and other issues as required
• Supervise and ensure timely reporting of claims/lawsuits to appropriate individuals, vendors, brokers, and/or insurers
• Work with the Company’s claims vendors to ensure that the Company is receiving high quality consistent service at the best price
• Develop and provide input with preparing claims handling instructions
• Schedule regular recurring claims reviews with our claims vendors
• Coordinate/monitor with claims vendors to verify appropriate reserves
• Monitor and participate in all high exposure and complex files
• Assist in overall case resolution strategies, negotiations, settlements, and litigation support where appropriate
• Work with our outside workers compensation attorney firms, monitor their workload for timely resolution of claims, and recommend changes where necessary
• Monitor and ensure our in-house medical vendor, medical provider networks (MPN), return to work/modified duty programs, and case management are effective and producing the desired results
• Work with our Senior Risk Management Analyst to evaluate data and identify claim trends
• Measure and track performance of physicians and attorneys who achieve the best outcome for our Company
• Provide input for forecasting and planning activities, and generate risk analysis reports for management
• Responsibility for working with claims vendors to negotiate and close legacy workers compensation claims
• Reports to the Senior Director of Risk Management
• Travel approximately 10% to 15%, mostly within California with some travel outside California
Required Experience:
• A minimum of 8+ years in claims adjusting experience either with a Third Party Administrator (TPA) or a nation-wide insurance broker
• Bi-lingual English/Spanish
• Have specific knowledge of workers compensation laws in the state of California
• Comprehensive understanding of medical terms as they relate to workers compensation a must
• Knowledge of disability terms and rules as they relate to workers compensation a must
• Knowledge of return to work/modified duty programs
• General knowledge of commercial general liability, business auto, property, and other coverage lines as they relate to claims
• Have a current California Claims Adjuster license or obtain one within six months of employment
• Associate in Claims® a plus
• Knowledge of GAB Robins Eye Advisor® claims data system a plus
• Knowledge of Broadspire Services, Inc. RSG claims data system a plus
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