California Workers Compensation Adjuster at The Jonus Group

Job DescriptionCalifornia Workers Compensation Adjuster (Permanent)Job SummarySeeking a highly skilled and experienced Workers Compensation Claims Adjuster to join a team. This role involves managing all aspects of workers compensation claims including determining compensability verifying coverage administering disability and medical benefits negotiating claim resolutions and providing exceptional service to injured employees employers and medical/legal professionals.Compensation PackageMedical dental and vision insuranceLife insurance401(K) with company matchOpportunities for professional growth and development in a supportive and collaborative environmentResponsibilitiesReceive and manage newly reported claimsMaintain and update claim notes throughout the lifespan of claimsRecord claim information in an electronic databaseConduct interviews with claimants insureds medical professionals and witnesses to determine claim validityCommunicate claim compensability decisions to claimants employers and medical providersSet appropriate reserves based on the nature and extent of injuriesCalculate lost time wages and administer disability paymentsCoordinate independent medical examinations and prepare relevant documentationMaintain regular correspondence with claimants insureds and nurse case managersReview and process medical bills through third-party vendors for additional discountsCollaborate with claimants and insureds to facilitate early return-to-workPartner with legal counsel to protect insured interests on litigated claimsAttend settlement conferences mediations and hearings on behalf of the company or insuredReview and approve defense attorney bills within authorityProvide relevant loss information to underwriting and risk management teamsRespond to state requests for health cost disputes applications for hearings and penalty assessment lettersIdentify subrogation opportunities and pursue recoveryLead claim reviews with clients as requestedPerform other duties as assignedQualifications/RequirementsMinimum of 10 years of experience adjusting Workers Compensation Claims in CaliforniaSIP Certification is requiredBilingual proficiency in Spanish and English is requiredCurrent with Continuing Education Units (CEUs)Proficiency in the Microsoft Office suiteIn-depth knowledge of California workers compensation lawsStrong understanding of medical terminology and treatment progressionExcellent oral and written communication skillsExceptional attention to detail and organizational abilitiesProven negotiation skills for resolving issues and settlementsStrong customer service orientation with a commitment to timely responsesAdaptability to changing technologies and new systemsAbility to establish and maintain effective working relationships with others#LI-BR1 Key Skills Accounts Administration,Customer Service,Advocacy,ABAP,Electronics,Bakery Employment Type : Full-Time Experience: years Vacancy: 1