10 senior workers compensation claims adjuster jobs found in San Diego

WHAT WE'RE LOOKING FOR BHHC has an immediate opportunity for experienced Workers Compensation Claims Professionals. This position requires a self-starter who can work under minimum direction, can achieve defined results, and willing to accept ownership for their work product. The Senior Claims Professional is responsible for the management of a complex caseload of workers compensation indemnity claims from inception to resolution.  This individual works under general supervision with elevated reserve and settlement parameters and encouraged to participate in special projects focused on process efficiency.    RESPONSIBILITIES Helps injured workers achieve rapid and full medical recovery and early, safe return to work through effective, efficient and timely medical treatment and return-to-work support. Effectively communicates with injured workers and employers. Demonstrates expertise and empathy, building trust and moving the claim forward, including timely...

The Claims Quality Assurance serves as the technical claims expert for the Claims Operations by auditing compliance with established CorVel, industry and carrier claim handling standards. The primary responsibility is evaluating claim handling quality, accuracy, and timeliness in categories including but not limited to: coverage analysis, investigation, valuation, reserving, compliance and accurate disposition of claims. This role has the ability to interpret results and trends in order to deliver operational reporting, and participate in the development and presentation of training.   This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Model ethical behavior and executes job responsibilities in accordance with CorVel’s core values, ethics, and information protection policies Serve as technical QA lead to assigned offices or departments Lead QA projects and serve as primary coordinator for senior leadership of assigned offices Support...

Are you looking to make an impactful difference in your work, yourself, and your community? Why settle for just a job when you can land a career? At ICW Group, we are hiring team members who are ready to use their skills, curiosity, and drive to be part of our  journey as we strive to transform the insurance  carrier space. We're proud to be in business for over 50 years, and its change agents like yourself that will help us continue to deliver our mission to create the best insurance experience possible. Headquartered in San Diego with regional offices located throughout the United States, ICW Group has been named for ten consecutive years as a Top 50 performing P&C organization offering the stability of a large, profitable and growing company combined with a focus on all things people. It's our team members who make us an employer of choice and the vibrant company we are today. We strive to make both our  internal and external communities better everyday! Learn more...

The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel. This is a remote position. Candidates are required to have CA RN License and Compact License. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the referral...

The Telephonic Case Manager coordinates resources and develops cost-effective, personalized care plans for ill or injured individuals. The goal is to support quality treatment and, when appropriate, a timely return to work. This role uses clinical expertise to assess the appropriateness of current treatment plans based on the patient’s medical and physical condition. The Case Manager communicates directly with treating physicians to evaluate and recommend alternative care options when needed. They also explain medical conditions and treatment plans to patients, family members, and adjusters, while supporting the objectives of the Case Management department and of CorVel. This is a remote part-time position. Candidates are required to have CA RN License and Compact License. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Provide medical case management to individuals through coordination with the patient, the physician, other health care providers, the employer, and the...

The Senior Liability Claims Specialist manages mid to complex Auto and/or General Liability claims, including bodily injury and property damage. This role aims to achieve optimal outcomes for both CorVel and our clients. The Senior Liability Claims Specialist handles litigated files and works with delegated authority, adhering to company best practices. This is a remote role. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Investigates claims and handles Auto and/or General Liability claims Establishes reserves and authorizes payments within reserving authority limits Communicates claim status with the customer, claimant, and client Adheres to client and carrier guidelines and participates in claims review as needed Collaborates with team members on more complex or problematic claims as necessary Additional duties as assigned...

The Senior Liability Claims Specialist manages mid to complex Auto and/or General Liability claims, including bodily injury and property damage. This role aims to achieve optimal outcomes for both CorVel and our clients. The Senior Liability Claims Specialist handles litigated files and works with delegated authority, adhering to company best practices. This is a remote position. ESSENTIAL FUNCTIONS & RESPONSIBILITIES: Receives claims, confirms policy coverage and acknowledgment of the claim Determines validity and compensability of the claim Investigates claims and handles Auto and/or General Liability claims Establishes reserves and authorizes payments within reserving authority limits Communicates claim status with the customer, claimant, and client Adheres to client and carrier guidelines and participates in claims review as needed Collaborates with team members on more complex or problematic claims as necessary Additional duties as assigned...

WHAT WE'RE LOOKING FOR Berkshire Hathaway Homestate Companies has an immediate opportunity for an experienced workers compensation adjuster. We're looking for self-starters who can work under minimum direction, can achieve defined results, and are willing to accept ownership for their work product. This Claims Professional is responsible for the management of a caseload of workers compensation indemnity claims from inception to resolution, performing initial investigation and compensability determination, reserve analysis and strategic planning, timely benefit administration to injured workers, and coordination of medical care and legal process, while maintaining the highest level of service to our insureds.   ESSENTIAL RESPONSIBILITIES Conducts the investigation of reported claims via three-point contact calls to determine coverage, compensability and severity, and to gather all other relevant information, documenting all relevant information thoroughly and...

Berkshire Hathaway Homestate Companies, Workers Compensation Division, has an opening in our San Diego office for a Claims Unit Supervisor. This individual will provide oversight and guidance to a team of Claims Professionals in the strategic management of workers' compensation indemnity claims while ensuring gold-standard service to injured workers and our insureds.   LEADERSHIP RESPONSIBILITIES Leads a unit of five to seven Claims Professionals of varying experience levels.  Establishes a workplace culture of professionalism, collaboration and inclusion, and excellence in service, aligning with our corporate mission and shared values. Establishes common goals.  Provides effective performance feedback through employee recognition, rewards, and disciplinary action, with the assistance of Human Resources as necessary. Able to transition between Supervisor and Claims Professional roles to effectively complete tasks and accomplish goals.  Actively...

Company Details   Preferred Employers Insurance, A Berkley Company specializes in providing workers’ compensation insurance to California business owners. The company serves three major Product/Client Segments: Small Business, Mid-Larger Businesses and Group Association Members (Programs). The company’s distribution partners (agents & brokers) number just under 400 locations throughout the state. Preferred serves thousands of policyholders and provides medical claims handling and claims management as needed to care for injured workers. The company is rated A+ Superior by industry-rating organization, AM Best & Company.   Company URL:      https://www.peiwc.com   The company is an equal opportunity employer. Responsibilities Preferred Employers Insurance is entering an exciting chapter of growth, and our Claims team will play a pivotal role in shaping our success in the year ahead. We’re looking for...