[Hiring] California Claims Professional Adjuster @K2 Security Insurance

Role Description

Midwestern Insurance Alliance (MIA) is seeking a full-time Claims Adjuster to join its worker’s compensation claims processing team.

Claims Adjuster responsibilities include, but are not limited to:

• Thoroughly investigating worker’s compensation claims by contacting injured workers, medical providers, and employer representatives.
• Determining if claims are valid under applicable worker’s comp statutes.
• Communicating with medical providers to develop and authorize appropriate treatment plans.
• Reviewing and analyzing medical bills to confirm charges and treatment are worker’s comp injury-related and in accordance with the treatment plan.
• Ensuring payments for medical bills and income replacement are remitted on a timely basis in accordance with applicable fee schedules and statutes.
• Calculating and assigning appropriate reserves to claims, and managing reserve adequacy throughout the life of the claim.
• Managing claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets.
• Preparing required state filings within statutory limits.
• Providing information as needed for litigation or settlement negotiations.

Qualifications

• Bachelor’s degree preferred, but not required.
• At least 2 years’ WC claims adjusting experience that includes experience with California WC claims.
• AB1262 California Experienced Examiner designation or currently meet the requirements for designation under AB1262.
• WCCA or WCCP preferred.
• Strong verbal and written communication skills.
• Strong organizational skills with attention to details.
• Ability to work with little supervision.
• Ability to manage multiple tasks in a fast-paced environment.
• Proficiency in MS Word, Excel, and Outlook.

Benefits

• Medical, dental, vision, disability, and life insurance.
• 401(k) with employer match.
• Business casual work environment.
• 8:00-5:00 Monday-Friday work week.

Salary

90,000-95,000 USD Annually