Experienced Workers' Compensation Claims Adjuster - CA Licensed, Remote Contract Opportunity with Competitive Hourly Rate

Join Fairbanks Claims Administration as a Senior Workers' Compensation Claims Adjuster and Drive Success in a Dynamic Remote Work Environment

Fairbanks Claims Administration, a leading high-deductible and self-insured workers' compensation Third-Party Administrator (TPA), is seeking an experienced and skilled Workers' Compensation Claims Adjuster to join their team on a remote contract basis. As a Senior Claims Adjuster, you will play a crucial role in investigating, evaluating, and adjusting assigned claims in accordance with established claim handling standards and laws.

About the Role

This is a fantastic opportunity for a seasoned claims adjuster looking for a challenging and rewarding role in a remote work setting. As a Senior Claims Adjuster, you will be responsible for managing a caseload of workers' compensation claims, ensuring timely and effective resolution, and providing excellent customer service to clients and stakeholders.

Key Responsibilities

• Investigate, evaluate, and adjust claims in accordance with established claim handling standards and laws.
• Establish reserves and/or provide reserve recommendations within established reserve authority levels.
• Review, approve, or provide oversight of medical and legal estimates and miscellaneous invoices to determine if reasonable and related to designated claims.
• Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
• Negotiate settlements in accordance with best practices, client-specific handling instructions, and state laws, when appropriate.
• Assist in the selection, referral, and supervision of designated claim files sent to outside vendors (i.e., legal, surveillance, case management, etc.).
• Review and maintain personal diary on claim system.
• Assess and monitor subrogation claims for resolution.
• Prepare reports detailing claim status, payments, and reserves, as requested.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Conduct claim reviews and/or training sessions for clients, as requested.
• Attend and participate in hearings, mediations, and informal legal conferences, as appropriate.
• Administer benefits on claims.
• Ensure timely utilization review (UR) processing.
• Process bills promptly.
• Communicate effectively with injured workers, clients, and attorneys.
• Maintain proper documentation of the claim file in a timely manner.
• Provide summary updates every 30, 60, or 90 days.
• Drive claims to resolution.
• Perform other duties as assigned.

Essential Qualifications

To be successful in this role, you will need:

• A California Adjuster's License (mandatory).
• 5+ years of experience as a claims examiner handling semi-complex to complex-level claims.
• Excellent oral and written communication skills.
• Initiative to set and achieve performance goals.
• Good analytical and negotiation skills.
• Ability to cope with job pressures in a constantly changing environment.
• Knowledge of all lower-level claim position responsibilities.
• Detail-oriented and a self-starter with strong organizational abilities.
• Ability to coordinate and prioritize tasks.
• Flexibility, accuracy, initiative, and the ability to work with minimum supervision.
• Discretion and confidentiality required.
• Reliable, predictable attendance within client service hours for the performance of this position.
• Responsive to internal and external client needs.
• Ability to clearly communicate verbally and/or in writing, both internally and externally.

Preferred Qualifications

While not mandatory, having the following qualifications will be a plus:

• SIP/WCCA/WCCP/AIC certifications.
• Proficient in ClaimPilot.

What We Offer

Fairbanks Claims Administration offers a competitive hourly rate of $50/hour for this contract-to-permanent opportunity. As a remote worker, you will enjoy the flexibility and autonomy to work from anywhere, while still being part of a dynamic and supportive team.

In addition to the competitive compensation, you can expect:

• A professional and supportive work environment.
• Opportunities for career growth and development.
• A flexible and autonomous work arrangement.
• Access to cutting-edge technology and tools.
• A collaborative and dynamic team.

Why Join Fairbanks Claims Administration?

Fairbanks Claims Administration is a leading TPA that values its employees and is committed to providing a supportive and inclusive work environment. By joining their team, you will become part of a dynamic and experienced group of professionals who are passionate about delivering exceptional service to clients.

As a Senior Claims Adjuster, you will have the opportunity to:

• Develop your skills and expertise in a supportive and collaborative environment.
• Take on new challenges and responsibilities.
• Work with a talented and experienced team.
• Enjoy a flexible and autonomous work arrangement.
• Access opportunities for career growth and development.

How to Apply

If you are a motivated and experienced claims adjuster looking for a new challenge, we encourage you to apply for this exciting opportunity. Even if you feel you're not a perfect match, we'd still love to hear from you. We are looking for great people to join our friendly team.

Don't miss this chance to take your career to the next level. Apply now and join Fairbanks Claims Administration as a Senior Workers' Compensation Claims Adjuster!