Farmers Insurance Group
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Westlake Village,
CA
Performs all technical claims activities relating to workers' compensation indemnity claims, which include the more difficult and serious files and may require specialized experience.
Position Requirements
Interprets coverage and makes recommendations to supervisor on the resolution of coverage questions. Ascertains and verifies employment, and determines if injury arose out of (and during course of) employment. Completes workers compensation status and reserve evaluation on all assigned cases. Secures evidence and information by office conference, telephone, correspondence, and by making necessary field investigations. Contacts employee by telephone, correspondence or in person, and explains workers' compensation benefits. Determines nature, extent, and duration of disability; reviews with doctors; authorizes medical care and examinations; and maintains medical control of all claims. Determines monetary value of disabilities, and authorizes weekly indemnity. Negotiates settlements within extent of authority, and issues claims drafts or checks in payment of claims. Contacts, investigates, and negotiates subrogation settlements on assigned cases. Establishes and controls diary for file control. Assists in training Workers' Compensation Claims Representatives. Performs other functions as assigned.
Preferred Skills and Abilities
Must be CA certified Workers Comp Claims Adjuster. Must have 3 years experience as Claims Adjuster.
Physical Actions
Bending Pulling Sorting Carrying up to 20 lbs. Pushing Speaking (English) Climbing Reaching Standing Key entering Reading (English) Walking Kneeling Seeing Writing (English)
Physical Environment
Required job duties are normally performed in a climate-controlled office environment, but with exposure to some or all of the following environments when in the field: Uncontrolled outside environmental conditions Excessive Noise Levels Chemicals Chemical/Biological Conditions Moving Mechanical Parts Areas considered dangerous Conditions, which could affect the respiratory system or skin such as: fumes, odors, dust, mists, gases, oils, smoke, soot, or poor ventilation.
Education Requirements
Four-year college degree. Completion of, or actively pursuing a major insurance designation, or actively pursuing insurance related courses.
Experience Requirements
Successful completion of technical competency exam required. Internal candidates may take the exam after six months as a senior work comp claim representative (if a high or mid-high contributor; mid-level contributors may take the exam after 12 months). External candidates have 90 days from date of hire to take and pass the exam and should have a minimum of two years of prior claims experience.
Special Skills Requirements
Communication Personal Computer Literate Valid driver's license Bondable Note: May be called upon to perform job duties outside of standard business hours.
Westlake Village, CA
Westlake Village, California
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