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Intercare Holdings Insurance Services
Intercare Holdings Insurance Services
201 – 500 Angajați
AsigurăriManagementul riscului
Intercare Holdings Insurance Services activează în domeniul asigurărilor și al gestionării riscurilor, ajutând organizațiile să gestioneze cererile de despăgubire pentru accidente de muncă și răspundere civilă, să coordoneze îngrijirea medicală gestionată și să reducă expunerea la riscuri. Serviciile sale combină administrarea daunelor cu fluxuri de lucru susținute de tehnologie, expertiză în gestionarea riscurilor și o Unitate internă de Investigații Speciale axată pe identificarea posibilelor fraude. În calitate de furnizor privat, Intercare oferă un model de servicii menit să îmbine capacitatea unei organizații mari cu promptitudinea și personalizarea unei firme mai mici, sprijinind clienții prin strategii practice pentru controlul costurilor, reducerea riscurilor și stabilitatea financiară.
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Locurile de muncă ale companiei

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.

USStatele Unite ale AmericiiCACalifornia
95.000 $ – 102.000 $ / an
HibridNormă întreagăSeniorLiderLimbă Obligatorie: englezăSpecialist în daune

Descriere

  • 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

Cerințe

  • 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

Beneficii

  • 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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