Senior Workers' Compensation Adjuster - Remote Texas

Richfield, Ohio
Not Specified
Sep 29, 2016
Nov 28, 2016
Job Type
Not Specified
Career Level
Not Specified

With over 25 years of success, National Interstate (NASDAQ: NATL) is one of the leading specialty property and casualty insurance companies in the country. We offer more than 30 product lines with a focus on commercial transportation, Alternative Risk Transfer (ART), and specialty vehicle insurance. Here at National Interstate, we believe that providing quality and commitment to our customers as well as our employees is paramount to our success. Thanks to our talented and dedicated team, we are truly able to build an insurance experience around you. If you are ready to join an engaging and driven team such as ours, we would love to hear from you!

As a Workers Compensation Senior Claims Examiner, you will be responsible for investigating and handling all assigned workers compensation claims by making timely contact to all involved parties to determine if any benefits are due under current state statutes. You will also serve as a key contact in your assigned jurisdiction for insureds that have questions or concerns regarding their claims or laws in the state. Desirable candidates will be able to effectively:

  • Thoroughly investigate all claims to determine if the injury or disease claimed by the injured worker arises out of and occurs in the course and scope of employment and therefore requires payment of medical or wage loss benefits

  • Analyze the claim's exposure in order to set reserves to maximum probable exposure and notify appropriate parties of increases within the predetermined reserve amounts in accordance with departmental procedures

  • Maintain a claims diary along with an organized file, documented with clear, concise notes, for easy review by supervisors, auditors, etc. which would be readily available for review as needed

  • Maintain communication with the insured, injured worker, medical provider, and any other persons involved throughout the claim to ensure all proper benefits due are timely paid.

  • Determine when vendor involvement is necessary, such as medical case management, vocational rehabilitation counseling, legal, surveillance, etc. and direct and monitor the vendor services to ensure the effective cost containment of expenses on claims

  • Assign, monitor, and direct defense counsel in settlement negotiations and claim handling to bring the claim to resolution

  • Perform other duties as assigned

Skills and Background we are looking for:

  • Bachelor's degree preferred or equivalent work experience

  • Exceptional written, verbal and interpersonal communication talent is highly preferred

  • Working knowledge of internet resources and Microsoft Office Suite

  • Strong critical thinking and analytical abilities

  • Must comfortable and confident with your ability to interpret insurance policies, perform basic research, and analyze factual situations to make sound decisions utilizing these resources to determine coverage and compensability of claims