Description
Job Opportunity: Workers' Compensation Claims Manager Key Requirements:
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SIP Certification: Preferred
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Salary: Up to $100k
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Experience:
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10+ years of workers' compensation (WC) claims experience
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Indemnity & litigation experience is a must
Work Arrangement: Onsite role (5 days a week in the office)
Office Location:
1st Preference: Roseville, CA
2nd Preference: Long Beach, CA
Primary Purpose:-
Analyze complex or technically difficult WC claims to determine benefits due.
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Handle high-exposure claims involving litigation and rehabilitation.
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Ensure ongoing adjudication of claims within service expectations, industry best practices, and specific client service requirements.
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Identify subrogation opportunities and negotiate settlements.
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Claims Management:
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Investigate and gather information on complex WC claims.
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Develop action plans for timely and appropriate claim resolution.
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Negotiate settlements within designated authority.
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Assign and manage reserves throughout the claim lifecycle.
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Process claim payments and adjustments.
Legal & Compliance:
Manage litigation processes to ensure cost-effective resolutions.
Prepare state filings within statutory limits.
Report claims to excess carriers and provide necessary responses.
Cost Control & Recovery:
Utilize cost-containment techniques to reduce claim costs.
Manage claim recoveries, including subrogation, Second Injury Fund excess recoveries, and Social Security/Medicare offsets.
Client & Vendor Coordination:
Maintain professional client relationships.
Communicate claim activity and processing with claimants and clients.
Coordinate vendor referrals for investigations and litigation management.
Administrative Responsibilities:
Ensure proper claim documentation and coding accuracy.
Refer cases to supervisors or management as needed.
Additional Functions & Responsibilities:-
Perform other assigned duties.
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Support the organization's quality programs.
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Travel as required.
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Bachelor's degree preferred.
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Professional certification (as applicable) preferred.
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Minimum 5 years of claims management experience or an equivalent combination of education and experience.
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Expertise in insurance principles, WC laws, claim processes, recoveries, and cost containment.
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Strong negotiation, analytical, and organizational skills.
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Excellent oral and written communication.
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Proficiency in Microsoft Office.
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Ability to work in a team-oriented environment and meet/exceed service expectations.
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Mental: Strong problem-solving, decision-making, and multitasking abilities.
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Physical: Computer usage and travel as required.
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Auditory/Visual: Clear hearing, vision, and verbal communication.
Note: Credit security clearance (background check) is required for this position.
As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.
Get a complete career fit with Kelly®.
You're looking to keep your career moving onward and upward, and we're here to help you do just that. Our staffing experts connect you with top companies for opportunities where you can learn, grow, and thrive. Jobs that fit your skills and experience, and most importantly, fit right on your path of where you want to go in your career.About Kelly
Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.
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