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Intercare Holdings Insurance Services
Intercare Holdings Insurance Services
201 – 500 Xodimlar
Sug‘urtaXatarlarni boshqarish
Intercare Holdings Insurance Services sug‘urta va xatarlarni boshqarish sohalarida faoliyat yuritib, tashkilotlarga xodimlar kompensatsiyasi va javobgarlik bo‘yicha da’volarni boshqarish, boshqariladigan tibbiy xizmatlarni muvofiqlashtirish hamda xatarlarni nazorat qilishda yordam beradi. Kompaniya xizmatlari da’volarni ma’muriy boshqarishni texnologiyaga asoslangan ish jarayonlari, xatarlarni boshqarish bo‘yicha tajriba va ehtimoliy firibgarlikni aniqlashga e’tibor qaratadigan ichki Maxsus tekshiruvlar bo‘limi bilan birlashtiradi. Xususiy kompaniya sifatida Intercare yirik tashkilot imkoniyatlarini kichik firmaga xos tezkorlik va moslashtirilgan xizmat bilan uyg‘unlashtirishga qaratilgan xizmat modelini taklif etadi. U mijozlarni xarajatlarni nazorat qilish, xatarlarni kamaytirish va moliyaviy barqarorlikni ta’minlashga xizmat qiladigan amaliy strategiyalar bilan qo‘llab-quvvatlaydi.
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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.

USAmerika Qo‘shma ShtatlariCAKaliforniya
95 000 $ – 102 000 $ / yil
GibridTo‘liq stavkaSeniorYetakchiTalab Qilinadigan Til: inglizchaSug‘urta da’volari bo‘yicha mutaxassis

Tavsif

  • 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

Talablar

  • 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

Imtiyozlar

  • 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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