Bilingual Work Comp Adjuster - CA

Job Title: Workers' Compensation Adjuster

Location: Remote

Position Overview: As a Workers' Compensation Adjuster, you will play a critical role in managing and resolving workers' compensation claims efficiently and effectively. You will be responsible for investigating claims, evaluating coverage, determining liability, and negotiating settlements in compliance with relevant laws and company policies. Additionally, you will collaborate with various stakeholders, including claimants, employers, medical professionals, and legal counsel, to ensure timely and fair resolution of claims.

Key Responsibilities:

• Conduct thorough investigations of workers' compensation claims to determine coverage, liability, and compensability.
• Analyze medical records, reports, and other relevant documentation to assess the extent of injuries and the need for medical treatment.
• Communicate with claimants, employers, witnesses, and other stakeholders to gather information and evidence pertaining to claims.
• Evaluate claim damages, including medical expenses, lost wages, and other compensatory benefits, to determine appropriate settlement amounts.
• Negotiate settlements with claimants, attorneys, and insurance carriers to resolve claims efficiently and fairly.
• Maintain accurate and detailed claim records, documentation, and correspondence in compliance with regulatory requirements and company standards.
• Collaborate with internal teams, including claims management, legal, and risk management, to provide updates on claim status and escalate complex issues as needed.
• Stay informed about changes in workers' compensation laws, regulations, and industry trends to ensure compliance and optimize claims management practices.

Qualifications:

• Bachelor's degree in business, insurance, finance, or related field preferred.
• Minimum of 5 years of experience in workers' compensation claims management or related field.
• Strong understanding of workers' compensation laws, regulations, and insurance principles.
• Excellent analytical, negotiation, and problem-solving skills.
• Exceptional communication and interpersonal skills with the ability to interact effectively with diverse stakeholders.
• Proficiency in computer applications, including claims management software and Microsoft Office Suite.
• Ability to work independently and collaboratively in a fast-paced, deadline-driven environment.
• Possess relevant certifications (e.g., Workers' Compensation Claims Professional) preferred.

Benefits:

• Competitive salary commensurate with experience
• Comprehensive benefits package including health, dental, and vision insurance
• Retirement savings plan with employer match
• Paid time off and holidays
• Professional development and training opportunities