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Directs the daily operations of a designated employee team, maintains service quality, handles employee-related human resources matters, protects confidential information, reviews operational and financial reports, and may support limited marketing and sales activities. The role requires strong communication, organization, analytical skills, customer service orientation, computer proficiency, and knowledge of applicable laws and procedures.

Handles complex workers’ compensation claims by investigating compensability, establishing reserves, authorizing payments, coordinating return-to-work efforts, managing subrogation and litigation, negotiating settlements, reporting claims, and communicating with customers and claimants. Maintains regulatory compliance, claim documentation, customer relationships, and cost-containment action plans. Requires at least three years of claims experience, a claims adjuster license or certification, and ongoing workers’ compensation certification.

Reviews workers’ compensation claim files, analyzes defenses, negotiates and resolves medical treatment liens, gathers supporting documents, prepares hearing packets and legal pleadings, and participates in WCAB conferences, trials, and hearings. The role requires strong communication, organization, problem-solving, Microsoft Office proficiency, and knowledge of WCAB procedures, labor codes, and state regulations.

Handles complex Workers’ Compensation claims, including investigation, compensability decisions, reserves, payments, subrogation, litigation, settlements, recoveries, and return-to-work coordination. Communicates with claimants, customers, attorneys, case managers, and carriers while maintaining regulatory compliance, documentation, and professional relationships. Supports claims reviews and helps team members develop claims knowledge.

Closes client files according to client protocols, applies results in Scheck and CareMC, verifies documentation, follows quality-control procedures, and maintains HIPAA compliance. The role requires accurate, organized work in a fast-paced production environment, along with professional communication, problem-solving, analytical ability, independent judgment, and proficiency in Microsoft Office, especially Excel.

Manages lower-level, non-complex workers’ compensation claims under senior supervision. Responsibilities include verifying coverage, determining compensability, establishing reserves, authorizing payments within delegated limits, communicating claim status, following client and carrier guidelines, and assisting with complex claims. The role requires strong communication, analytical, organizational, and computer skills, along with the ability to work independently and collaboratively in a remote environment.

Handles complex California workers’ compensation claims, including coverage verification, compensability investigations, reserves, payments, subrogation, litigation, recoveries, settlement negotiations, and return-to-work coordination. The role communicates with customers, claimants, attorneys, case managers, and carriers; maintains regulatory compliance and claim documentation; and supports cost containment and favorable claim outcomes. This is a remote position requiring licensed or certified workers’ compensation claims-handling experience.

Manages lower-complexity workers’ compensation claims under senior supervision. Responsibilities include confirming coverage, determining claim compensability, establishing reserves, authorizing payments within delegated limits, managing lost-time claims, communicating with stakeholders, following client and carrier guidelines, and assisting with complex claims. The role requires strong communication, analytical, organizational, and technical skills, along with a bachelor’s degree or equivalent experience, at least one year of industry experience, and an active workers’ compensation license or certification.

Handles complex workers’ compensation claims from investigation through resolution, including coverage verification, compensability decisions, reserves, payments, subrogation, litigation, recoveries, settlement negotiations, and return-to-work coordination. Communicates with claimants, customers, attorneys, case managers, carriers, and state agencies while ensuring regulatory compliance, accurate documentation, cost containment, and adherence to client and carrier guidelines.

Owns the Enterprise Claims liability product by analyzing performance, utilization, user feedback, and data to identify improvements. Collaborates with development, QA, support, and product teams to define requirements, prioritize enhancements, validate functionality, ensure regulatory compliance, and optimize workflows. Supports documentation, training, testing, troubleshooting, and continuous improvement initiatives while serving as a subject matter expert for liability claim management processes.