Be Here. Be Great. Working for a leader in the insurance industry means opportunity for you. Great American Insurance Group’s member companies are subsidiaries of American Financial Group. We combine a "small company" culture where your ideas will be heard with "big company" expertise to help you succeed. With over 35 specialty property and casualty operations, there are always opportunities here to learn and grow.

We value diversity and recognize the benefits gained when people from different cultures, backgrounds and experiences work collaboratively to achieve business results. We are intentionally focused on fostering an inclusive culture and know valuing diversity is an essential leadership quality. Our goal is to create a workplace where all employees feel included, empowered, and enabled to perform at their best.

At Republic Indemnity, we’ve been helping businesses in the western U.S. manage their Workers’ Compensation costs for over 50 years.  Headquartered in Calabasas, California with additional offices in San Francisco and San Diego, we write workers compensation primarily in CA with significant business in AK, AZ, NV, and other western states.  Whether it’s helping a broker, policyholder, injured worker, or a colleague, Republic is all about creating a clear way forward so people can reach their goals. If you share that vision, we’d love to talk with you about our exiting opportunity for Workers’ Compensation Medical Only Claims Adjuster. This position has the potential for growth for the right candidate.

This position is based in our Calabasas office with a hybrid schedule of a minimum of 1 day per week in the office.

Essential Job Functions and Responsibilities

• Manage all aspects of workers’ compensation medical-only claims from initiation to closure, ensuring excellent customer relations throughout.
• Review claim and policy information to provide context for investigations.
• Conduct ongoing investigations, gathering facts  from insured parties, claimants, and medical providers.
• Assess gathered information to determine the compensability of medical treatments.
• Administer statutory medical-only benefits promptly throughout the claim’s lifecycle.
• Set reserves within authority limits for medical expenses and recommend reserve adjustments to the Team Leader as needed.
• Regularly review claim status and recommend solutions to the Team Leader for any issues.
• Report unusual or potentially undesirable exposures to the Team Leader.
• Refer appropriate claims to subrogation and secure necessary information to maximize recovery opportunities.
• Collaborate with in-house claims Team to exceed customer expectations for exceptional claims handling service.
• Performs other duties as assigned.

Technical Skills & Competencies:

• Entry-level Medical Only Claim Examiner position.
• Knowledge of insurance, claims, and workers’ compensation statutes and regulations is a plus, but on-the-job training will be provided.
• Commitment to superior performance that adds value to the company and customers.
• Ability to work effectively with a diverse range of people.
• Aptitude for evaluating, analyzing, and interpreting information.
• Excellent telephonic and organizational skills.
• Ability to multi-task with proven time management skills to meet deadlines.
• Ability to work well in teams.
• Demonstrate critical thinking and decision-making abilities.
• Excellent verbal and written communication skills.

Job Requirements

• Bachelor’s Degree preferred but not required.
• Prior experience in medical-only or similar claim handling is a plus but not required.
• Proficiency with Microsoft Office products.
• Experience in a fast-paced, dynamic environment.
• Strong communication and telephonic skills.
• Medical Only Claim Adjuster designation in California is a plus.
• Knowledge of medical terminology is a plus but not required.
• Knowledge of bill processing is a plus but not required.

Company:

RICA Republic Indemnity Company of America

Salary Range:

$27.50 -$32.50

Benefits:

The wage range for this job is based on role, level, and location. Within the range, individual pay takes into account a variety of factors that are considered in making compensation decisions including but not limited to skills, education, training, licensure and certifications, experience of the candidate, the role’s scope, complexity, and other business and organizational needs. In addition to the base compensation, we offer a competitive Total Rewards package, which includes but is not limited to medical, dental, vision, paid time off, and 401(k) plan for full-time and part-time employees who are eligible for benefits.

Your recruiter may be able to tell you more about our total rewards offerings and the specific wage range for the relevant location(s) during the hiring process.