Claims Examiner Job Listing at Kelly Services in Ontario, CA (Job ID US3557046_BH9783767)

Description

Finding a job that fits your lifestyle isn't always easy. That's where Kelly® comes in. We're seeking a Claims Examiner to work in a leading provider of technology-enabled risk, benefits, and integrated business solutions company in Ontario, CA. Sound good? Take a closer look below. We're here to help you find something great that works for you—so you won't miss a moment of what really matters in your life. 

 Why you should apply to be a Claims Examiner: 

•  Opportunity to work with a reputable integrated business solutions company. 

• Convenient M-F Remote in CA. 

• Current pay rate is $50.00/hr. 

 What's a typical day as a Claims Examiner. You'll be: 

 The Claims Examiner is responsible for managing complex California Workers' Compensation claims from initial investigation through resolution, ensuring compliance with state laws and client expectations. They analyze claim exposure, determine benefits due, and develop strategic action plans for timely and cost-effective outcomes. This role requires the examiner to handle litigated files, coordinate with legal counsel and vendors, and effectively negotiate settlements within authority limits. Accurate reserve setting, state filings, and thorough documentation are essential aspects of the role. Additionally, the examiner must maintain proactive communication with claimants, clients, and other stakeholders throughout the claim lifecycle. 

Essential Duties and Responsibilities  

• Analyze and manage complex or technically challenging California Workers' Compensation claims  

• Investigate claims and assess exposure and benefits due  

•  Develop and implement action plans for efficient claim resolution  

•  Calculate and assign reserves, manage reserve adequacy  

•  Approve, adjust, and issue claim payments in a timely manner  

•  Prepare state filings in accordance with statutory timelines  

•  Handle litigated claims and manage vendors for legal and investigative services  

•  Use cost containment strategies to control claim expenses  

•  Identify and pursue subrogation opportunities  

•  Report claims to excess carriers when necessary  

•  Communicate claim status to clients and claimants  

•  Maintain accurate documentation and proper claims coding  

•  Escalate complex issues to supervisor or management when appropriate  

 

This job might be an outstanding fit if you have:  

• Minimum 3 years of recent California Workers' Compensation claims handling experience  

• SIP Certification – Mandatory  

• High School Diploma or GED  

• Strong knowledge of CA WC regulations, claims process, and litigation  

• Experience managing litigated and complex claims 

• Public entity claims experience  

• Experience with County of Los Angeles claims 

  

What happens next  
Once you apply, you'll proceed to the next steps if your skills and experience look like a good fit. But don't worry—even if this position doesn't work out, you're still in our network. That means all of our recruiters will have access to your profile, expanding your opportunities even more. 

  

Helping you discover what's next in your career is what we're all about, so let's get to work. Apply to be a Claims Examiner today! 

As part of our promise to talent, Kelly supports those who work with us through a variety of benefits, perks, and work-related resources. Kelly offers eligible employees voluntary benefit plans including medical, dental, vision, telemedicine, term life, whole life, accident insurance, critical illness, a legal plan, and short-term disability. As a Kelly employee, you will have access to a retirement savings plan, service bonus and holiday pay plans (earn up to eight paid holidays per benefit year), and a transit spending account. In addition, employees are entitled to earn paid sick leave under the applicable state or local plan. Click here for more information on benefits and perks that may be available to you as a member of the Kelly Talent Community.

Get a complete career fit with Kelly®.

You're looking to keep your career moving onward and upward, and we're here to help you do just that. Our staffing experts connect you with top companies for opportunities where you can learn, grow, and thrive. Jobs that fit your skills and experience, and most importantly, fit right on your path of where you want to go in your career.

About Kelly

Work changes everything. And at Kelly, we're obsessed with where it can take you. To us, it's about more than simply accepting your next job opportunity. It's the fuel that powers every next step of your life. It's the ripple effect that changes and improves everything for your family, your community, and the world. Which is why, here at Kelly, we are dedicated to providing you with limitless opportunities to enrich your life—just ask the 300,000 people we employ each year.

Kelly is committed to providing equal employment opportunities to all qualified employees and applicants regardless of race, color, sex, sexual orientation, gender identity, religion, national origin, disability, veteran status, age, marital status, pregnancy, genetic information, or any other legally protected status, and we take affirmative action to recruit, employ, and advance qualified individuals with disabilities and protected veterans in the workforce. Requests for accommodation related to our application process can be directed to the Kelly Human Resource Knowledge Center. Kelly complies with the requirements of California's state and local Fair Chance laws. A conviction does not automatically bar individuals from employment. Kelly participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S.

 Apply on company website