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Berkshire Hathaway Homestate Companies

Posted 4 months ago

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Claims Adjuster

SacramentoHybridFull-time

AI Summary

A Spanish-speaking Workers’ Compensation Claims Adjuster trainee investigates and resolves claims, manages medical care and legal processes, calculates reserves, and builds client relationships from case inception to resolution.

About this role

WHAT WE'RE LOOKING FOR
Are you searching for a unique opportunity that offers exceptional training and career growth with a dynamic and growing organization? Are you a Spanish speaker looking to apply those skills in a professional environment? Berkshire Hathaway Homestate Companies is searching for bright individuals looking to begin a challenging, yet rewarding career path as a Workers’ Compensation Claims Adjuster.
Upon successful completion of the Claims Training program, the Claims Adjuster Trainee will be responsible for management of a caseload of workers compensation claims from inception to resolution. Responsibilities include initial investigation and analysis, strategic planning, management of medical care and legal process, and client relations. This individual will continue to build on claims knowledge and claims will increase in number and complexity.

ESSENTIAL RESPONSIBILITIES

  • Successfully completes classroom training introducing workers compensation claims handling strategies, medical terminology, statutory requirements, and investigative skills.
  • Conducts initial investigation of reported claims to determine coverage, compensability, severity, and gather all other relevant information via three-point contact telephone calls.
  • Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines.
  • Develops and updates a Plan of Action for the successful resolution of each claim.
  • Makes prompt, sound decisions on issues that arise based on the best information available, ensuring that work is performed in accordance with Company guidelines and applicable statutory requirements. Timely escalates issues/red flags to Supervisor.
  • Ensures benefits due injured worker are calculated and issued appropriately in accordance with legal requirements including the issuance of appropriate notices and filings.
  • Fosters a positive and close working relationship with internal and external partners, including Call Center, Medical Management, Special Investigations, and Indemnity Adjusting Staff.

    • REQUIRED QUALIFICATIONS

  • Minimum of High School Diploma or equivalent certificate required; Bachelor’s degree from four-year college or university is preferred.
  • Ability to communicate effectively verbally and in writing; Spanish Fluency ability a plus.
  • Solid interpersonal and customer service skills.
  • Ability to manage and prioritize multiple assignments in a fast-paced environment.
  • Strong organization skills to ensure tasks are completed within hard deadlines.
  • To perform this job successfully, an individual should be proficient in the Microsoft Office Suite of applications and be proficient, or able to become proficient, on applicable databases, systems, and vendor software programs.

    • WHAT WE OFFER

  • Full Training Program
  • Growth and advancement opportunities
  • Work - Life Balance
  • Manageable Caseloads
  • Modernized Historical Setting in East Sacramento
  • Free Lot Parking

    • BENEFITS

  • Paid Time Off
  • Paid Holidays
  • Retirements Savings Match
  • Group Health Insurance (Medical, Dental, and Vision)
  • Life and AD&D Insurance
  • Long Term Disability Insurance
  • Accident and Critical Illness Insurance
  • Flexible Savings Accounts
  • Paid Community Volunteer Day
  • Employee Assistance Program
  • Tuition Reimbursement Program
  • Employee Referral Program
  • Diversity, Equity and Inclusion Program

    • Skills

    Claim Reserves CalculationClaims DatabasesInvestigative SkillsMedical TerminologyMicrosoft OfficeStatutory RequirementsVendor Software ProgramsWorkers' Compensation Claims Handling

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