Intercare Holdings Insurance Services
Intercare Holdings Insurance Services
201 – 500 कर्मचारी
जोखिम प्रबंधनबीमा
Intercare Holdings Insurance Services बीमा और जोखिम प्रबंधन के क्षेत्र में कार्य करती है और संगठनों को कर्मचारियों के मुआवज़े तथा देयता संबंधी दावों का प्रबंधन करने, प्रबंधित देखभाल का समन्वय करने और जोखिम के प्रभाव को नियंत्रित करने में सहायता देती है। इसकी सेवाओं में दावा प्रशासन, प्रौद्योगिकी-सक्षम कार्यप्रवाह, जोखिम प्रबंधन विशेषज्ञता और संभावित धोखाधड़ी की पहचान पर केंद्रित एक आंतरिक विशेष जांच इकाई शामिल है। एक निजी स्वामित्व वाली सेवा प्रदाता के रूप में, Intercare का मॉडल बड़े संगठन की क्षमता को छोटी फर्म की तत्परता और अनुकूलनशीलता के साथ जोड़ने का प्रयास करता है, ताकि ग्राहकों को लागत नियंत्रण, जोखिम में कमी और वित्तीय स्थिरता के लिए व्यावहारिक रणनीतियाँ मिल सकें।

Workers' Compensation Claims Adjuster III (Hybrid)

Senior workers’ compensation claims adjuster overseeing catastrophic, litigated, and high-exposure indemnity files. Leads settlements, litigation, reserves, recovery, medical coordination, and technical support for complex claims.

विवरण

  • Conduct three-point contact on new losses and apply enhanced review to complex, catastrophic, and high-exposure claims
  • Create detailed action plans and strategic resolution approaches for assigned indemnity files
  • Recognize potential fraud and refer qualifying cases to the Special Investigations Unit
  • Collect and document facts involving multiple-party liability, catastrophic injuries, substantial subrogation opportunities, or novel legal issues
  • Lead medical management for catastrophic and highly complex claims
  • Direct specialists, coordinate life care planners, oversee utilization reviews and independent medical examinations, and manage permanent total disability cases
  • Work with case managers to support early return-to-work outcomes
  • Review high-cost and unusual medical treatments for appropriateness
  • Lead permanent disability ratings for complex claims
  • Set and update reserves for high-exposure files
  • Prepare status reports that meet client deadlines and formatting requirements
  • Manage litigation independently, including defense counsel selection, strategy, expert retention, legal spending, and trial preparation
  • Lead mediations, settlement conferences, and arbitrations
  • Make or recommend high-value settlement authority decisions with the Claims Supervisor and client
  • Negotiate and complete high-value settlements, including Compromise and Release agreements and Stipulated Awards
  • Resolve multiple liens and coordinate with lien counsel and the Centers for Medicare & Medicaid Services
  • Pursue subrogation, contribution from multiple defendants, and apportionment recoveries
  • Coordinate recovery vendors and external subrogation counsel
  • Provide technical coverage for the Claims Supervisor
  • Advise on complex claim decisions, reserve adequacy, and escalated client matters
  • Mentor Adjuster I and Adjuster II colleagues and contribute to unit-wide quality reviews
  • Act as the senior contact for key client accounts
  • Develop and maintain client and carrier relationships
  • Communicate proactively and transparently with stakeholders while meeting required response times

आवश्यकताएँ

  • At least 7 years of workers’ compensation claims experience, including 5 years independently managing indemnity claims with complex, high-exposure, and litigated files; alternatively, a bachelor’s degree with at least 5 years of independent workers’ compensation indemnity experience, or an equivalent combination
  • Broad knowledge of public entity liability claims, including joint powers authorities, self-insured programs, and pooled insurance arrangements
  • Active adjuster license in applicable states; multi-state licensing is preferred
  • California Self-Insured Plan certificate required for California files
  • Advanced knowledge of applicable state workers’ compensation statutes, with strong California expertise preferred
  • Hands-on experience with one or more claims administration or processing platforms used in workers’ compensation or insurance claims
  • Proven ability to direct complex litigation through mediation, settlement conferences, and trial preparation
  • Advanced knowledge of permanent disability ratings, Medicare Set-Aside requirements, and multi-party lien resolution
  • Experience managing catastrophic injuries and coordinating life care planning
  • Familiarity with claims management systems
  • Proficiency with Microsoft Office
  • Ability to mentor junior adjusters and act as supervisory backup or a senior technical resource
  • Strong client relationship management skills, including handling escalated concerns at a senior level
  • Professional credentials such as AIC, ARM, WCCP, or CPCU are preferred but not required

लाभ

  • Medical, dental, and vision coverage
  • Company contributions toward HSA and FSA plans
  • Employer-paid life and disability insurance
  • 401(k) plan with company matching
  • Paid time off and company-paid holidays
  • Employee assistance resources
  • Workplace culture that supports balance and wellbeing
  • Comprehensive benefits package

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