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Disability Claims Assistant Jobs in California (NOW HIRING)

JT2 Integrated Resources

Claims Examiner

Oakland, CA · On-site

Train and direct Claims Assistants to meet goals and deadlines. * Review and approve priority ... disability status, genetics, protected veteran status, sexual orientation, gender identity or ...

Discovery Cube

Human Resources Coordinator

Santa Ana, CA

$21.75 - $28.50/hr

Complete and submit EDD notices related to unemployment and disability claims. * Assist with documentation related to leave administration and employee status updates. General HR Support * Serve as a ...

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Disability Claims Assistant information

What does a disability claims assistant do?

A Disability Claims Assistant helps process and manage disability insurance claims by collecting relevant documentation, verifying information, and communicating with claimants and healthcare providers. They support claims examiners by reviewing forms, entering data, and ensuring all paperwork is complete and accurate. Their role is crucial in ensuring that disability claims are handled efficiently and fairly, assisting individuals who are unable to work due to illness or injury.

What skills and qualifications are needed to thrive as a disability claims assistant?

To thrive as a Disability Claims Assistant, you need strong organizational skills, attention to detail, and a solid understanding of medical and insurance terminology, often supported by a high school diploma or equivalent. Familiarity with claims management software, databases, and office productivity tools such as Microsoft Office is typically required. Excellent communication, empathy, and problem-solving skills help you effectively interact with claimants and coordinate with other departments. These abilities ensure accurate processing, efficient handling of sensitive information, and a positive experience for clients navigating disability claims.

How does a disability claims assistant typically collaborate with other departments during the claims process?

As a Disability Claims Assistant, you will regularly work with multiple departments, such as medical review teams, customer service representatives, and legal advisors. Effective communication and coordination are essential, as you'll be gathering necessary documentation, clarifying claim details, and ensuring all required information is shared accurately and promptly. This collaborative approach helps streamline the claims process and ensures claimants receive timely decisions. Building strong relationships with colleagues in other departments can make your work smoother and lead to better outcomes for both the organization and clients.

What is the role of a disability claims assistant?

A disability claims assistant supports the processing of disability benefit claims by reviewing applications, verifying documentation, and ensuring accuracy. They often use specialized software, communicate with claimants, and follow established procedures to facilitate timely and accurate claim decisions.

What are the most commonly searched types of Disability Claims jobs in California?

The most popular types of Disability Claims jobs in California are:

What cities in California are hiring for Disability Claims Assistant jobs?

Cities in California with the most Disability Claims Assistant job openings:

Disability Claims Assistant jobs near you

Experienced Claims Adjuster

Berkshire Hathaway Homestate Companies

Sacramento, CA • On-site, Remote

$70K - $95K/yr

Full-time

Medical, Dental, Vision, Life, PTO

Re-posted 13 days ago

Job description

WHAT WE'RE LOOKING FOR
Berkshire Hathaway Homestate Companies has an immediate opportunity for an experienced workers compensation adjuster. We're looking for self-starters who can work under minimum direction, can achieve defined results, and are willing to accept ownership for their work product.
 
This Claims Professional is responsible for the management of a caseload of workers compensation indemnity claims from inception to resolution, performing initial investigation and compensability determination, reserve analysis and strategic planning, timely benefit administration to injured workers, and coordination of medical care and legal process, while maintaining the highest level of service to our insureds.
ESSENTIAL RESPONSIBILITIES
  • Conducts the investigation of reported claims via three-point contact calls to determine coverage, compensability and severity, and to gather all other relevant information, documenting all relevant information thoroughly and escalating the investigation for further investigation when appropriate.
  • Calculates appropriate reserves for each claim and ensures that reserves are adjusted as needed per authority guidelines.
  • Calculates and administers benefits in accordance with statutory requirements, including timely issuance of appropriate notices and filings.
  • Develops and updates a Plan of Action for the successful resolution of each claim; timely updates Plan as new information is obtained.
  • Makes prompt, sound decisions on issues that arise in claims based on the best information available, ensuring that work is performed in accordance with Company standards, training, supervisory direction, and applicable laws.  Timely escalates issues/red flags to Supervisor and/or appropriate internal team.
  • Ensures that the actions of all other professionals involved in claim, including attorneys, nurse case managers, and investigators, are coordinated to achieve a successful resolution of the claim.
  • Assigns appropriate tasks to a Claims Assistant and/or Claims Clerical Assistant and ensures they are performed correctly and efficiently.
  • Accurately and thoroughly prepares litigation referrals, AOE/COE investigation referrals, and MSA referrals for submission to vendor; obtains proper approval from Management.
  • Prepares timely and accurate settlement recommendations (within designated authority parameters) and effectively negotiates settlement of claims.
  • Fosters a positive and close working relationship with partner company staff, including the Call Center, Medical Management, Special Investigations, Client Services, Underwriting, and Claims Legal.
  • Communicates effectively with individuals outside the company, including clients, medical providers, and injured workers.
  • Collaborates with Adjusting staff and relevant interdepartmental personnel on special projects focused on process efficiency.
  • Ensures continual education requirements are met.
REQUIRED QUALIFICATIONS
  • EDUCATION: Minimum of a High School diploma required or equivalent certificate required; Bachelor's degree from four-year College or university preferred.
  • DESIGNATION: Designated as a Claims Adjuster or Experienced Claims Adjuster per the California Code of Regulations and has completed the minimum required continuing education credits to adjust workers compensation claims for the State of California; Self-Insured certification a plus.
  • EXPERIENCE: Minimum of three years of indemnity adjusting experience managing large and/or complex claims and accounts within a workers’ compensation carrier required
  • Maintains qualifying educational criteria to adjust workers’ compensation claims for the State of California; Self-Insured certification preferred. 
  • Inquisitive, critical thinker; agile learner with adaptive, smart time management skills.
  • To perform this job successfully, an individual should be proficient in the Microsoft Office Suite of applications (highly proficient in Excel preferred), and be proficient on applicable databases, systems and vendor software programs.
WHAT WE OFFER
  • Work-Life Balance
  • Work From Home Program (up to 2 days per week)
  • Reasonable caseload with in-house Medical Management support (UR, Med Bill Review, Resource Nurses); In-house Claims Assistant support
  • Free On-Site Parking
  • Paid Time Off
  • Paid Holidays
  • Retirements Savings Match
  • Group Health Insurance (Medical, Dental, and Vision)
  • Life and AD&D Insurance
  • Long Term Disability Insurance
  • Accident and Critical Illness Insurance
  • Flexible Savings Accounts
  • Paid Community Volunteer Day
  • Employee Assistance Program
  • Tuition Reimbursement Program
  • Employee Referral Program
  • Diversity, Equity and Inclusion Program
This pay scale is an estimate of the salary range the employer reasonably expects to pay for the position based on potential employee qualifications, operational needs and other considerations consistent with applicable law. The actual salary may be above or below the range. The pay scale applies only to this position and only if it is filled in California. The pay scale may be different for other positions or in other locations.
ABOUT US
With more than 50 years in business, BHHC has grown from a regional organization to a national insurance group, offering insurance products from coast to coast. Relationships are the cornerstone of our culture, and we believe in doing the right thing. That means we invest in our business in every way possible to deliver on our mission and demonstrate that people are what powers our success. Our commitment to financial strength and integrity means our customers can rest assured that we will be there when it counts.
 
At BHHC we embrace diversity and foster an environment where our people can be their authentic selves. Our differences make us stronger and better together, which fosters a harmonious workplace—something we truly value. We’ve created an approachable and collaborative atmosphere. Here you’ll find a welcoming workplace where everyone can feel valued, supported, and inspired to do great work. Together, we raise the bar by being curious, remaining customer-focused, and operating with integrity.