Senior Workers' Comp Claim Adjuster

 Experienced (Non-Manager)
 $50,000 - $74,999
 Thursday, January 16, 2020

SUMMARY

Investigates and evaluates losses while developing a plan of action to bring claims to proper resolution in a timely manner. Experience level preferably between 5-7 years. 

JOB REQUIREMENTS:

  • Determines extent of insurance coverage and compensability on each filed claim
  • Investigates claims, including interviewing employees, employers and witnesses
  • Obtains necessary records, including but not limited to, hospital records, police reports, physician records, etc.
  • EDI and CMS/Section 111 reporting
  • Utilizes appropriate preferred vendors
  • Presents thorough and accurate reports to clients and excess carriers on claims investigations/situations
  • Negotiates settlements for resolutions with claimants and their attorneys
  • Maintains control of litigation activities and costs per account requirements
  • May be asked to mentor, train and/or share expertise with other staff
  • May be asked to serve as back up to supervisor or manager when they are unavailable.
  • Attends meetings; conferences; workshops or training sessions; and reviews written material to maintain current knowledge on principles, practices and new developments in assigned work areas
  • Maintains and meets state specific licensing requirements
  • Responds to client questions and comments in a courteous and timely manner
  • Is responsible for catastrophic losses, complex litigation, and other sensitive issues
  • All other duties as assigned

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

  • Ability to understand and follow oral and/or written policies, procedures and instructions
  • Ability to perform a wide variety of duties and responsibilities with accuracy and speed, while meeting time-sensitive deadlines
  • Ability to conduct investigations in multi-party situations
  • Ability to use standard or customized software applications appropriate to assigned tasks
  • Ability to prepare and present accurate, reliable and factual reports with recommendations
  • Thorough knowledge of current principles and practices associated with claims investigations, adjustment and related practices
  • Extensive knowledge of medical and legal terminology with a thorough understanding of legal principles/litigation management 
  • Ability to handle confidential information
  • Ability to communicate effectively with others both orally and in writing
  • Ability and willingness to learn quickly and utilize new skills as a result of rapidly changing information and/or technology
  • Ability to comprehend multi-state laws and regulations to assist other offices, as necessary 
  • REQUIRED EXPERIENCE: Should have 5-7 years’ experience in handling workers’ compensation claims.  A college degree or equivalent business experience needed.  Must have a current license in Nevada. 

CLICK HERE TO SUBMIT YOUR APPLICATION TODAY!
POWERED BY: