2 senior workers compensation claim representative jobs found

Company Details   BerkleyNet is an innovative workers compensation insurance provider that does all of our business online. Our Goal? To make doing business “Ridiculously Fast. Amazingly Easy.” Responsibilities   Investigate workers’ compensation claims by interviewing injured workers, witnesses, and policyholders to verify coverage and determine compensability and benefits due Calculate and set timely financial reserves and proactively manage reserve adequacy throughout claim lifecycle Record and code injured worker demographics, job information and accident information in company’s claims management system and files necessary forms with state regulatory agencies Issue timely payments to injured workers, medical providers and service vendors Coordinate and actively manage medical treatment of injured workers to ensure timely rehabilitation Negotiate settlements of claims within designated authority with...

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...