[Work From Home] Senior Claim Representative I, California

Remote Full-time
Build your professional journey with workwarp, starting as a Senior Claim Representative I, California Workers' Compensation Experience Required, REMOTE! Join our team in the heart of Remote and enjoy a dynamic work environment. This position requires a strong and diverse skillset in relevant areas to drive success. In recognition of your expertise, this position offers a salary of a competitive salary. Â Â Job Description

Must have California Workers' Compensation experience.
Must reside within the U.S. and to work PST work hours.

This position serves as a technical expert in the claim handler career path. Under limited supervision, handles claims with litigation, complex/catastrophic and/or coverage elements. Handles the most unique cases, where little precedence has been established. May handle the most complex, high touch or labor intensive customers. Serves as a department leader by developing other employees and may function as acting manager in the absence of department management.

RESPONSIBILITIES/TASKS:

Senior Claim Representative I:
• Independently administers complex claims and catastrophic exposures within authority, including claims from dedicated large accounts.
• Establishes timely and appropriate reserves based on claim profile and anticipated financial exposure.
• Represents the Company by working closely with customers, agents and brokers to resolve the most complex claim issues.
• Negotiates settlements with attorneys or injured and exercises independent judgment to settle cases prior to mediation or litigation.
• Manages outside vendors to ensure cost containment efforts.
• Establishes and maintains effective working relationships with all internal and external customers.
• Stays abreast of changes in workers' compensation statutes, case law and rehabilitation efforts/advancements in order to accurately interpret and apply relevant laws.
• Actively participates in agent/client relationship management.
• Mentors team members.
• May serve as department leader in the absence of management or act as manager designee.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

EMPLOYMENT QUALIFICATIONS

EDUCATION OR EQUIVALENT EXPERIENCE:

Bachelor's degree in a related field. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.

EXPERIENCE:

Senior Claim Representative I:

Seven years of progressively more responsible experience in a workers' compensation claims environment that provides the necessary skills, knowledge and abilities, such as experience in reviewing, investigating and closing the most complex workers' compensation claims. Experience handling claims in multiple jurisdictions preferred. Bilingual skills preferred.

OR

Two years of AF Group Claims Representative III experience that includes independent handling of the most complex claims and/or the most complex, high touch or labor intensive customers.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

Senior Representative I:
• Ability and proficiency in the use of computers and company standard software specific to position.
• Knowledge of medical and legal terminology related to the work.
• Knowledge of workers' compensation laws and regulations, including jurisdictional laws.
• Effective oral and written communication skills.
• Effective customer service skills.
• Ability to negotiate, build consensus and resolve conflict.
• Ability to act as a representative of the Company and establish effective working relationships.
• Ability to manage multiple priorities and meet established deadlines.
• Attention to detail and analytical skills.
• Ability to make independent decisions.
• Ability to solve highly complex problems.
• Ability to train and mentor others.
• Ability to lead others.

WORKING CONDITIONS:

Work is performed in an office/remote setting with no unusual hazards. Minimal travel required.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

Pay Range "Actual compensation decision relies on the consideration of internal equity, candidate's skills and professional experience, geographic location, market and other potential factors. It is not standard practice for an offer to be at or near the top of the range, and therefore a reasonable estimate for this role is between $77,400 and $119,580."

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.

#LI-MG1 #CWU

About the Team

CompWest Insurance Company Apply Job! Join Our Team!This is a fantastic opportunity to grow your career. If you have the skills and passion we're looking for, please submit your application today.

Apply Now
Apply Now →

Similar Jobs

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote

USPS Office Helper

Remote

Experienced Customer Service Representative – Virtual Entry Level Position for Delivering Exceptional Financial Services and Driving Customer Satisfaction

Remote

New Entry-Level Remote Typing Jobs For Teens AT Chewy

Remote

**Experienced Part-Time Remote Data Entry Specialist – Flexible Schedule & Competitive Compensation**

Remote

Executive Director, Clinical Transformation and Delivery – Strategic Leadership for Medicaid and Medicare Population Health Management

Remote

[Remote] Customer Service Representative I (Spanish Speaking)

Remote

**Experienced Data Entry Specialist – Live Chat Support & Remote Operations for Netflix**

Remote

Experienced Remote Customer Service Representative for Non-Emergency Medical Transportation Program

Remote

Online Student Success Coach (m/w/d) | Flexibler Remote-Job

Remote

Analyst, Supplier Management & Delivery

Remote

Experienced Data Entry Specialist – Remote Opportunity at careerzynith

Remote
← Back