Claims Adjuster (Spanish Fluency Preferred)

ESSENTIAL RESPONSIBILITIES

Successfully completes classroom training introducing workers compensation claims handling strategies, medical terminology, statutory requirements, and investigative skills.

Conducts initial investigation of reported claims to determine coverage, compensability, severity, and gather all other relevant information via three-point contact telephone calls.

Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines.

Develops and updates a Plan of Action for the successful resolution of each claim.

Makes prompt, sound decisions on issues that arise based on the best information available, ensuring that work is performed in accordance with Company guidelines and applicable statutory requirements. Timely escalates issues/red flags to Supervisor.

Ensures benefits due injured worker are calculated and issued appropriately in accordance with legal requirements including the issuance of appropriate notices and filings.

Fosters a positive and close working relationship with internal and external partners, including Call Center, Medical Management, Special Investigations, and Indemnity Adjusting Staff.

REQUIRED QUALIFICATIONS

Minimum of High School Diploma or equivalent certificate required; Bachelor’s degree from four-year college or university is preferred .

Ability to communicate effectively verbally and in writing; Spanish Fluency ability a plus.

Solid interpersonal and customer service skills.

Ability to manage and prioritize multiple assignments in a fast-paced environment.

Strong organization skills to ensure tasks are completed within hard deadlines.

To perform this job successfully, an individual should be proficient in the Microsoft Office Suite of applications and be proficient, or able to become proficient, on applicable databases, systems, and vendor software programs.

WHAT WE OFFER

Full Training Program

Growth and advancement opportunities

Work - Life Balance

Manageable Caseloads

Modernized Historical Setting in East Sacramento

Free Lot Parking

BENEFITS

Paid Time Off

Paid Holidays

Retirements Savings Match

Group Health Insurance (Medical, Dental, and Vision)

Life and AD&D Insurance

Long Term Disability Insurance

Accident and Critical Illness Insurance

Flexible Savings Accounts

Paid Community Volunteer Day

Employee Assistance Program

Tuition Reimbursement Program

Employee Referral Program

Diversity, Equity and Inclusion Program