Claims Examiner III (Hybrid)

Job description

Job DetailsLevel: ExperiencedJob Location: Sacramento - Rancho Cordova, CA 95670Position Type: Full TimeSalary Range: $90,000.00 - $95,000.00 SalaryJob Shift: DayJob Category: InsurancePlease make sure that you complete all the questions and navigate to the end of the application to sign it. This position is a hybrid and a temp-to-hire opportunity. Must have SIP POSITION SUMMARY: At the Direction of the Claims Supervisor and/or Manager, manages all aspects of complex and litigated indemnity claims from inception to conclusion within established authority and guidelines. This position requires considerable interaction with clients, claimants, Medical providers, Attorneys, vendors, Nurse and Vocational Case Managers, and other TRISTAR staff. DUTIES AND RESPONSIBILITIES: Effectively manages a caseload of indemnity claim files, including very complex and litigated claims.* Initiates and conducts investigations in a timely manner.* Determines compensability of claims and administers benefits based upon state law and TRISTAR Best Practices for claim handling.* Manages medical treatment and medical billing, authorizing as appropriate.* Refers cases to outside defense counsel and participa...