Claims Representative - Workers Compensation - California
PMA Companies · Roseville, California, US
As a member of our Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve assigned claims of a...
Job description
As a member of our Claims team, utilize your knowledge of Workers Compensation Claims to independently investigate, evaluate and resolve assigned claims of a more complex nature in order to achieve appropriate outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance with legal statues, policy provisions, and company guidelines. Responsibilities: Target salary range - $62,000 - $88,000 #LI-Remote - Promptly investigates all assigned claims with minimal supervision, including those of a more complex nature - Determines coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable) - Alerts Supervisor and Special Investigations Unit to potentially suspect claims - Ensures timely denial or payment of benefits in accordance with jurisdictional requirements - Within granted authority, establishes appropriate reserves with documented rationale, maintains and adjusts reserves over the life of the claim to reflect changes in exposure - Negotiates claims settlements within granted authority - Establishes and implements appropriate action plans for case resolution including m...