Berkshire Hathaway Homestate Companies - Workers Compensation Division · 3 days ago
Senior Claims Adjuster - Workers Compensation
Sacramento, CA
Full-time
Hybrid
Senior Level, Lead/Staff
$86K/yr - $102K/yr
8+ years expBerkshire Hathaway Homestate Companies is seeking experienced Workers Compensation Claims Professionals. The Senior Claims Adjuster will manage a complex caseload of workers compensation indemnity claims, ensuring effective communication and resolution-focused strategies while working under general supervision.
Financial ServicesInsurance
Responsibilities
Helps injured workers achieve rapid and full medical recovery and early, safe return to work through effective, efficient and timely medical treatment and return-to-work support
Effectively communicates with injured workers and employers. Demonstrates expertise and empathy, building trust and moving the claim forward, including timely three-point contacts on all new losses
Manages claims with an outcome-based and resolution focus. Demonstrates highly effective strategic plans for future handling that are well outlined in plans of action and followed through in a timely fashion
Demonstrates effective decision making in compensability determinations and benefit authorizations (within designated authority parameters). Proactively utilizes resources such as Medical Management, SIU, Subrogation, Recovery and Legal to ensure accurate determinations in compensability, causal relationship, appropriate medical treatment, and to achieve favorable outcomes
Prepares and maintains timely, accurate reserves on all claims for expected future costs of medical treatment, benefits and other elements in accordance with Claims Handling Guidelines. Ensures reserves are escalated and approved as appropriate. Ensures there is appropriate reserve documentation in the file
Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates the settlement of claims
Reduces fraud through early identification and escalation
Effectively manages defense attorneys. Demonstrates excellence in litigation management by being prepared for hearings in a timely manner and appropriately considering exposures, settlement options, and other legal issues
Reviews and approves vocational rehabilitation plans
Effectively manages vendors and providers. Identifies need for assignment and removal of vendors and makes effective use of vendor expertise while maintaining ownership of the claim
Demonstrates expertise in technical aspects of claim management. Works with Medicare Set Asides, Structured Settlements and/or Part B issues
Maintains effective relationships with internal and external service partners, including participation in periodic telephonic claims reviews
Calculates and pays benefits in accordance with the law. Ensures that the claim as a whole is managed in accordance with all legal requirements including the issuance of appropriate notices and filings
Qualification
Required
Minimum of a High School diploma required or equivalent certificate required
Minimum of eight years of indemnity adjusting experience managing large and/or complex claims and accounts within a workers' compensation carrier required
Designated as a Claims Adjuster or Experienced Claims Adjuster per the California Code of Regulations and has completed the minimum required continuing education credits to adjust workers compensation claims for the State of California
Proficient in the Microsoft Office Suite of applications and be proficient, or able to become proficient, on applicable databases, systems, and vendor software programs
Preferred
Bachelor's degree from four-year College or university preferred
Self-Insured certification a plus
Maintains qualifying educational criteria to adjust workers' compensation claims for the State of California; Self-Insured certification preferred
Inquisitive, critical thinker; agile learner with adaptive, smart time management skills
Benefits
Generous Paid Time Off and Holidays
Excellent Benefits (Medical, Dental, Vision, 401k, etc)
Health and Wellness Reimbursement
Tuition Assistance Reimbursement
Discounts across companies such as GEICO, See’s Candies, etc.
Company
Berkshire Hathaway Homestate Companies - Workers Compensation Division
Financial Strength and Integrity With more than 50 years in business, BHHC has grown from a regional organization to a national insurance group, offering insurance products from coast to coast.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
A
Andy Linkhart
Chief Claims Officer and Chief Financial Officer
David Speights
Vice President of Analytics
Recent News
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