Claims Examiner - Medical Only
- Employer
- Preferred Employers Insurance
- Location
- San Diego, California
- Salary
- DOE
- Posted
- Mar 24, 2017
- Closes
- Apr 27, 2017
- Category
- Claims, Workers' Compensation
- Job Type
- Full Time
- Career Level
- Experienced (Non-Manager)
The Medical Only Claims Examiner is the first professional level of claim administration. This level examiner is closely supervised, has a general understanding of department objectives and is sufficiently knowledgeable in workers’ compensation laws to administer medical claims benefits. This position, is responsible for determining the validity of workers' compensation claims only involving medical workers' compensation benefits. The medical-only claims adjuster will also establish medical treatment reserves, approve and process medical benefits, and negotiate settlement of medical benefit claims. Medical Only claims consist of non-litigated, no lost time, soft tissue type injuries, including strains/sprains. In addition this position will also back-up the First Report Unit and Claims Assistant ACD phone group. Claims handling activities will be performed in compliance with the rules, regulations and statutes of the WCAB and the State of California. This position requires the Medical Only Claims Examiner to be certified pursuant to California statute. This may be done by classroom instruction, on the job experience, or some combination of both, in order to obtain the required 80 hours under supervision during the first year in the job.
Requirements:
1 year workers compensation claims examiner experience.