CA Workers' Comp Lien & Medical Management Adjuster – Remote (Rep I)
About The Position
We are seeking an experienced Workers’ Compensation Claim Representative I to handle California jurisdiction claims with a focus on lien resolution and lifetime medical management. This remote position supports multiple accounts within the staffing and transportation industries and requires an individual who can manage complex medical issues, negotiate lien settlements, and maintain strong compliance with state and client requirements. This role is ideal for someone who enjoys analytical problem-solving, communicating with medical providers and attorneys, and driving claims toward fair and timely resolution.
Requirements
- Minimum 2 years of workers’ compensation claim handling experience, with exposure to lien resolution and/or lifetime medical management.
- SIP certification or Experienced Adjuster designation.
- Excellent written and verbal communication skills.
- Strong time management and organizational abilities with attention to detail.
- Proficiency in Microsoft Office programs (Word, Excel, Outlook).
Nice To Haves
- Prior experience managing claims within the staffing or transportation industries.
Responsibilities
- Investigate, evaluate, and adjust workers’ compensation claims in accordance with established procedures and California regulations.
- Negotiate and settle liens with lien claimants, medical providers, and applicant attorneys.
- Handle future medical/lifetime medical claims, ensuring timely authorization and payment of treatment, services, and prescriptions.
- Review medical reports, legal correspondence, and billing to determine reasonableness and relatedness to ongoing claims.
- Coordinate with defense counsel and vendors to resolve complex lien disputes.
- Maintain current and accurate diary, documentation, and billing records.
- Ensure compliance with CCMSI standards, client requirements, and jurisdictional timeframes.
- Deliver exceptional customer service to clients, claimants, and internal partners.
Benefits
- Employee Ownership: As an Employee-Owned Company (ESOP), every employee has a stake in our success.
- Time Off: 4 weeks of paid time off in your first year, plus 10 paid holidays.
- Comprehensive Benefits: Medical, Dental, Vision, Life, Short- and Long-Term Disability, Critical Illness, and 401(k).
- Career Growth: Robust internal training and professional development opportunities.
- Supportive Culture: We believe in manageable caseloads, collaboration, and maintaining a healthy work-life balance.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
No Education Listed
Number of Employees
1,001-5,000 employees
