Intercare Holdings Insurance Services

Insurance

• Maintain a culture of positivity, respect, supportiveness, collaboration, patience, accountability, and excellence.
• Assist with team building ideas and events.
• Lead by example and through service.
• Develop and maintain strong and collaborative client relationships.
• Establish prompt contact on all new losses within 24 hours of receipt of the claim, including the insured, claimant, or claimant representative to document relevant facts and obtain information for liability and damage analysis.
• Thoroughly and accurately evaluate coverage on a timely basis, document coverage analysis, identify coverage issues, and draft appropriate coverage letters.
• Thoroughly and accurately investigate all claims, document ongoing case facts, perform and document ongoing evaluations, and note progress toward claim resolution.
• Litigation Management: Direct, manage, and control the litigation process for nationwide programs.
• Maintain all assigned claims on an active 30–45 day diary and keep an up-to-date plan of action.
• Obtain consultant and/or expert reviews for early evaluation.
• Aggressively pursue contribution on multi-defendant cases or those involving employment/independent contractor agreements with shared liability.
• Ensure all claims are handled in accordance with applicable statutes, service contracts, and company guidelines.
• Establish, monitor, and adjust reserves according to authority levels and client instructions.
• Exhibit a courteous and helpful attitude and project a professional image for the company and clients.
• Respond to phone messages within 24 hours and to written inquiries within one week.
• Travel for mediations, trials, client meetings, and/or industry conferences.
• Maintain working knowledge of medical terminology and jurisdictional issues.
• Handle other duties as assigned by Supervisor or Manager.

Liability Claims Adjuster III

• Manage to conclusion assigned inventory of medical professional and general liability claim files
• Maintain a culture of positivity, respect, supportiveness, collaboration, patience, accountability, and excellence
• Develop and maintain strong and collaborative client relationships
• Establish prompt contact on all new losses within 24 hours of receipt of the claim
• Thoroughly investigate all claims and document ongoing case facts and relevant information necessary for establishing liability and damages
• Direct, manage and control the litigation process for nationwide programs
• Assure that all assigned claims are maintained on an active 30–45-day diary
• Obtain consultant and/or expert reviews for early evaluation

• Investigate, analyze, and determine the extent of insurance provider's liability concerning personal, casualty, or property loss or damages, and attempt to effect settlement with claimants.
• Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information.
• Calculate benefit payments and approve payment of claims within a certain monetary limit.
• Investigate claims: assess and estimate vehicle damage; inspect property to determine damages; gather physical evidence; research property and legal records.
• Compile information through interviews; evaluate customer records; examine evidence to determine if it will support claims.
• Follow contract, property, or insurance laws and rules of evidence procedures in legal settings; comply with regulatory requirements.
• Evaluate liability exposure: review insurance applications and policies; obtain, review and evaluate records (police, medical, etc.); recommend claim action.
• Properly reserve for the claim and adjust reserve as appropriate; comply with accepted reserving guidelines and authority levels.
• Create and maintain records, reports, and files primarily on the SIMS and/or Renaissance system; maintain active diary on SIMS/Renaissance; prepare timely reports to clients; comply with GHC Procedure Manual reporting requirements.
• Litigation management support: collect evidence to support contested claims in court; keep clients advised.
• Other duties as assigned.

General Liability Claims Adjuster II

• Assist a Dynamic Team
• Provide ongoing coaching, counseling, and feedback to team members
• Ensure all claims are handled in accordance with relevant statutes and company guidelines
• Address personnel issues promptly and decisively
• Foster a collaborative and productive team environment focused on excellence in claim resolution

Workers' Compensation Claims Adjuster

• Investigate, analyze, and determine extent of insurer liability for personal, casualty, or property loss and attempt settlements.
• Correspond with or interview medical specialists, agents, witnesses, or claimants to compile information.
• Calculate benefit payments and approve payment of claims within monetary limits.
• Assess and estimate vehicle and property damage; inspect property and gather physical evidence.
• Research property and legal records, examine evidence, and follow contract/property/insurance laws and rules of evidence.
• Review insurance applications and policies to determine coverage and evaluate liability exposure.
• Obtain, review and evaluate records (police, medical, etc.) and recommend claim action; reserve and adjust claim reserves per guidelines.
• Create and maintain records, reports and active diaries in SIMS and/or Renaissance systems; prepare timely client reports.
• Provide litigation management support and keep clients advised; perform other duties as assigned.

• Reports directly to the unit Claims Supervisor and may provide technical backup in the absence of the Claims Supervisor.
• Manages an assigned inventory of claim files to conclusion, including cases of extreme complexity or unique/unusual issues, per statutes and company guidelines.
• Conducts a three-point contact within 24 hours of new losses (claimant, employer, treating physician) to document incident facts, disability and treatment status.
• Documents ongoing case facts and information for establishing compensability, disability payments, vendor use, medical/expense payments, and progress toward closure.
• Maintains up-to-date indemnity claim plans of action outlining activities for resolution.
• Partners with medical case manager to maximize early return-to-work, reducing extended disability and costs.
• Initiates referral to SIU for suspected fraud.
• Pursues subrogation, contributions on multiple-defendant cases, and apportionment where pre-existing disability exists.
• Ensures claim file handling complies with statutes, service contracts, and company guidelines.
• Reviews and approves vocational rehabilitation plans.
• Establishes, monitors, and adjusts reserves within authority.
• Reviews medical bills for appropriateness before referral to InterMed for payment.
• Maintains courteous, professional demeanor with timely responses to inquiries.
• Requires knowledge of California Labor Code and litigation management; may handle other duties as assigned.

Liability Claims Adjuster III

Liability Claims Adjuster III

General Liability Claims Adjuster II

Workers' Compensation Claims Adjuster

General Liability Claims Adjuster II

Workers Compensation Claims Adjuster III