Workers Compensation Claims Adjuster III

Workers Compensation Claims Adjuster III

Join to apply for the Workers Compensation Claims Adjuster III role at Inter Med Cost Containment Services.

Job Type: Full‑time.

Reports directly to the unit Claims Supervisor and may be called upon to provide technical backup in the absence of the Claims Supervisor. In accordance with applicable statutes and in keeping with company rules, regulations, and established performance objectives, you will be responsible for effectively managing to conclusion an assigned inventory of claim files that may include cases of extreme complexity or with unique or unusual issues.

• Perform a three‑point contact on all new losses within 24 hours of receipt of the claim to include the claimant, employer, and treating physician.
• Thoroughly and accurately document ongoing case facts and relevant information necessary for establishing compensability, the need for disability payments, the use of vendors, medical and expense payments, and what is being done to move the case toward closure.
• Maintain an up‑to‑date plan of action for each assigned indemnity claim to ultimately resolve the claim.
• Partner with the medical case manager to maximize early return to work, reducing the need for extended disability payments, vocational rehabilitation, and other protracted claim costs.
• Initiate referral to the SIU for cases with suspected fraud.
• Actively pursue subrogation from culpable third parties, contributions on multiple defendant cases, and apportionment when there is pre‑existing disability.
• Ensure that the claim file is handled in accordance with applicable statutes, service contracts, and company guidelines.
• Review and approve all vocational rehabilitation plans.
• Establish, monitor, and adjust monetary case reserves when warranted and in strict accordance with assigned authority levels.
• Review all medical bills for appropriateness prior to referral for payment and posting to the claim file.
• Maintain a courteous and helpful attitude and project a professional image on behalf of the company.
• Respond to telephone messages and inquiries within 24 hours and to written inquiries within one week.
• Demonstrate a working knowledge of the Labor Code of California as it pertains to workers’ compensation claims and the legal requirements for handling them.
• Manage litigation, including directing, controlling, and monitoring the litigation process.
• Perform other duties and tasks as directed by Supervisor or Manager.

• Required education:
  Bachelor’s degree (B.A.) from a four‑year college or university; or equivalent combination of education and experience.
• At least five years of experience managing indemnity cases, many with complex or high‑potential subrogation, rehabilitation, medical management, and/or legal issues.
• 70‑plus hours of experience or training related to claims handling required.
• Possession of an SIP certificate.
• Strong problem‑solving skills, customer‑service orientation, interpersonal aptitude, and teamwork abilities.

We’re an equal‑opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status. Pursuant to the Los Angeles and San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest or conviction records.

Salary: $85,000 – $105,000.