Job Description

Position: Workers' Compensation Claims Adjuster

Duration: San Bernardino, California

Location: 6+ months

The minimum qualifications are:

WORKERS COMPENSATION:

• Three (3) years of experience, within the last five (5) years, adjusting workers' compensation claims, including one (1) year adjusting complex litigated claims, such as continuous trauma, AOE/COE, stress claims, and safety claims.
• Ability to review Workers' Compensation claims, and reports and determine if occupational illness or injury is compensable; authorize and compute benefit payment (Temporary Total Disability, Permanent Disability, Life Pension).
• Ability to review and document claim reports from physicians, ability to investigate claims from onset to resolution.
• Ability to explain to injured workers their benefits and legal rights under Workers' Compensation Laws.
• Ability to prepare subrogation and litigation cases and correspond with doctors and attorneys on litigated cases.

GENERAL LIABILITY:

• Three (3) years of experience, within the last five (5) years, adjusting workers' compensation claims, including one (1) year adjusting complex litigated claims
• Reviews property and liability claims; determines the extent of County liability and estimates settlement value of claims; makes recommendations on the settlement or denial of claims; adjusts and settles claims within assigned monetary authority; and researches the applicable laws, codes, and resolutions.
• Determines coverages for the County's self-insurance liability program, which includes comprehensive, malpractice, auto, general liability, and employee personal property claims.
• Conducts office and field investigations to determine circumstances surrounding claims involving County vehicles, property, or employees; interviews witnesses, third-party investigators, and others; prepares reports of findings.
• Conducts interviews with persons responsible for damages to County property and injuries to employees to ensure payments; contacts public and private organizations to obtain collections information; recommends court actions and/or lien attachment when collections cannot be made.
• May authorize subrogation, recommend court actions and/or lien attachment when collections cannot be made by other means; review and make final recommendations for suspension, modification, garnishment, or other legal actions; correspond with attorneys, insurance carriers, and others; interpret the legal procedures and prerogatives involved in the collection of subrogation accounts.
• Represents the County in Small Claims Court.

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