California Licensed Claims Examiner

Job Summary

A company is looking for a Claims Examiner III.

Key Responsibilities

• Manage a caseload of 150 to 180 workers' compensation files, including complex claims
• Conduct claims investigations and determine compensability of claims in accordance with state law
• Communicate with claimants, providers, and vendors regarding claims issues and manage medical treatment and billing

Required Qualifications

• High School Diploma or GED required; Bachelor's degree in a related field preferred
• 1 to 5 years of related experience or equivalent combination of education and experience
• Technical knowledge of statutory regulations and medical terminology
• Certification and/or license as required by State regulation
• Proficiency in Word and Excel preferred