Workers Compensation Claims Adjuster, III

Intercare Holdings Insurance Services

Claims Adjuster managing complex indemnity cases for AvonRisk, a leading specialty risk manager. Collaborating with teams and ensuring efficient claims management and compliance.

Posted 7/3/2026full-timeRemote • California • 🇺🇸 United StatesSeniorLead💰 $95,000 - $100,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing indemnity claims, including case documentation, fraud referral, and subrogation processes. Proficient in collaborating with medical case managers and ensuring compliance with vocational rehabilitation plans.

Highest-signal resume keywords

Indemnity Claims ManagementClaims Handling ExpertiseSIP CertificateCase DocumentationFraud Referral

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ManagementCase Reserve MonitoringVocational Rehabilitation ReviewSubrogation PursuitMedical Bill Review

Soft Skills

Professional AttitudeCourteous Communication

Certifications & Qualifications

SIP Certificate

Industry Keywords

Claims SupervisorCompensabilityThree-Point ContactMedical Case ManagementFraud Investigation

About the role

Key responsibilities & impact

Reports directly to the unit Claims Supervisor
Provide technical backup in the absence of the Claims Supervisor
Manage an assigned inventory of claim files
Perform a three-point contact on all new losses
Document ongoing case facts and information for compensability
Ensure up to date plan of action for indemnity claims
Partner with medical case manager for early return to work
Refer cases with suspected fraud to SIU
Pursue subrogation from culpable third parties
Review and approve all vocational rehabilitation plans
Monitor and adjust monetary case reserves
Review medical bills for appropriateness prior to payment referral
Maintain a courteous and helpful attitude and project a professional image

Requirements

What you’ll need

Bachelor's degree (B. A.) from four-year college or university
At least seven years related experience and/or training
Equivalent combination of education and experience
Minimum of at least five years experience managing indemnity cases
High degree of claims handling expertise
SIP certificate

Benefits

Comp & perks

Comprehensive medical, dental, and vision benefits
Company contributions to HSA and FSA plans
Employer paid life and disability insurance
401(k) with company match
Paid time off (PTO) and company paid holidays
Learning and development opportunities that support real career advancement
Employee assistance resources and a supportive culture that values balance and wellbeing