The Mutual Group
Sr. Workers' Compensation Adjuster - California I Remote Opportunity
The Mutual Group, Culver City, California, United States, 90232
Overview
Sr. Workers' Compensation Adjuster - California I Remote Opportunity at The Mutual Group. The Senior Workers’ Compensation Adjuster is responsible for managing moderate to complex workers’ compensation claims from initial investigation through resolution. This remote position requires minimal supervision and relies on professional judgment and experience to achieve objectives. Responsibilities
Investigates coverage, determines compensability, initiates and controls delivery of accurate and timely workers' compensation benefits, monitors medical management, and determines accurate and adequate reserves on assigned claims. Provides accurate assessments and negotiates fair and efficient claim resolutions while managing costs. Settles losses according to the documented policy, regulatory and statutory considerations, and within granted authority. Prepares written communication, including settlement letters, disclaimers of coverage, and reservation of rights letters. Maintains effective claim file documentation and a diary system. Monitors diary to achieve timely development of the file and timely disposition of the claim. Recognizes and pursues recovery opportunities and prepares submissions to SIU when indicated. Assigns and supervises vendor resources, including independent adjusters, engineers and other experts as needed. Assumes additional duties as defined. Qualifications
Bachelor's degree preferred 5-8 years in the handling of Workers' Compensation Claims Knowledge of Workers' Compensation Law Multi-line claim handling experience beneficial Ability to take responsibility and work independently in a home-based environment Strong communication and analytical skills Ability to negotiate skillfully in difficult situations Strong organizational and time management skills Ability to formulate sound expense, indemnity, and business judgment while supporting loss evaluations State licensing or certification where required Basic computer skills including Microsoft Word, Excel, Outlook, and Internet Perform math problems and calculations relevant to claims Compose written correspondence and factual reports with proper English, grammar, punctuation, and spelling Demonstrates ability to use commonly used claims concepts, practices, and procedures Convey clear, concise information to others Complete formal training plans and assignments as required Treat others in a nondiscriminatory, lawful, and ethical manner Follow safe practices in all work activities Compensation
$68,700 - $100,000 commensurate with experience, plus bonus eligibility $75,600 - $115,000 commensurate with experience in CA, CT, MA, NJ, NY, and PA, plus bonus eligibility Benefits
Competitive base salary plus incentive plans for eligible team members 401(K) retirement plan with company match of up to 6% Free basic life and AD&D, long-term disability and short-term disability insurance Medical, dental and vision plans Wellness incentives Generous time off program including personal, holiday and volunteer paid time off Flexible work schedules and hybrid/remote options for eligible positions Educational assistance
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Sr. Workers' Compensation Adjuster - California I Remote Opportunity at The Mutual Group. The Senior Workers’ Compensation Adjuster is responsible for managing moderate to complex workers’ compensation claims from initial investigation through resolution. This remote position requires minimal supervision and relies on professional judgment and experience to achieve objectives. Responsibilities
Investigates coverage, determines compensability, initiates and controls delivery of accurate and timely workers' compensation benefits, monitors medical management, and determines accurate and adequate reserves on assigned claims. Provides accurate assessments and negotiates fair and efficient claim resolutions while managing costs. Settles losses according to the documented policy, regulatory and statutory considerations, and within granted authority. Prepares written communication, including settlement letters, disclaimers of coverage, and reservation of rights letters. Maintains effective claim file documentation and a diary system. Monitors diary to achieve timely development of the file and timely disposition of the claim. Recognizes and pursues recovery opportunities and prepares submissions to SIU when indicated. Assigns and supervises vendor resources, including independent adjusters, engineers and other experts as needed. Assumes additional duties as defined. Qualifications
Bachelor's degree preferred 5-8 years in the handling of Workers' Compensation Claims Knowledge of Workers' Compensation Law Multi-line claim handling experience beneficial Ability to take responsibility and work independently in a home-based environment Strong communication and analytical skills Ability to negotiate skillfully in difficult situations Strong organizational and time management skills Ability to formulate sound expense, indemnity, and business judgment while supporting loss evaluations State licensing or certification where required Basic computer skills including Microsoft Word, Excel, Outlook, and Internet Perform math problems and calculations relevant to claims Compose written correspondence and factual reports with proper English, grammar, punctuation, and spelling Demonstrates ability to use commonly used claims concepts, practices, and procedures Convey clear, concise information to others Complete formal training plans and assignments as required Treat others in a nondiscriminatory, lawful, and ethical manner Follow safe practices in all work activities Compensation
$68,700 - $100,000 commensurate with experience, plus bonus eligibility $75,600 - $115,000 commensurate with experience in CA, CT, MA, NJ, NY, and PA, plus bonus eligibility Benefits
Competitive base salary plus incentive plans for eligible team members 401(K) retirement plan with company match of up to 6% Free basic life and AD&D, long-term disability and short-term disability insurance Medical, dental and vision plans Wellness incentives Generous time off program including personal, holiday and volunteer paid time off Flexible work schedules and hybrid/remote options for eligible positions Educational assistance
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