Job Details

Workers' Compensation Claims Representative - Hybrid Remote- Fresno, CA

Join a well-established insurance agency with a 30-year legacy and a powerful commitment to ethical, honest insurance solutions. They are actively seeking an experienced Workers' Compensation Claims Representative! You will drive success by investigating and evaluating claims, expediting payments, and ensuring proper documentation. Grow your expertise with a team ready to invest in your long-term professional development.

What's in it for you?

• Earn an annual salary of $70,000 - $90,000+, depending on your experience
• Comprehensive benefits package including Medical, Dental, and Vision insurance
• 401(k) plan
• Generous Paid Time Off (PTO) and paid company holidays

What we need from you:

• 3-5+ years of experience in workers' compensation claims
• Certifications as a Workers Compensation Claims Administrative (WCCA) and Workers Compensation Claims Professional (WCCP) are preferred but not required
• Knowledge of Worker's Compensation guidelines, Medicare coding, and compliance obligations.
• Microsoft Office and other database management systems

The Position:

• Assisting with new claims from opening until satisfactory completion, evidence, and fact-gathering surrounding claims
• Ensuring claims coding is true and accurate
• Claim files must be accurately recorded in the system
• Assuring all claims have a workable plan of action
• Reviewing billing summaries
• Identifying any signs of fraud and making proper referrals for further investigation
• Pursue subrogation when necessary and offer superior customer service to all parties involved