Adjuster - Workers Compensation

LOST TIME CLAIMS REPRESENTATIVE:   The Lost Time Workers’ Compensation Claims Representative is responsible for quality handling and resolution of complex workers’ compensation claims in a timely, professional manner with an emphasis on providing quality service while controlling expenses.  Position routinely handles claims involving complex return-to-work issues, complex injuries and litigated workers’ compensation issues.

Responsibilities:

• Investigate and process Georgia workers’ compensation claims from assignment to conclusion.
• Interview claimant and witnesses to gather pertinent information.
• Work with the injured worker and telephonic case manager to medically manage the claim from initial medical to reviewing and evaluating on going medical information.
• Provide consistent customer service to the State Agency and injured worker through timely responses to all inquiries, telephone calls and emails while delivering on service commitments.
• Review incoming mail daily; respond as needed to bring the claim to a prompt conclusion, seeking supervision as needed.
• Evaluate and set reserves for ultimate exposure.
• Timely filing of Board forms.
• Timely filing of wage loss benefits.
• Ensure accurate and timely entry of required data information.
• Work directly with employers to facilitate a return to work either to a full-time or modified duty basis.
• Maintain a current diary on outstanding claims.
• Provide direction and guidance to defense attorneys and other experts while controlling costs.
• Meet or exceed specific objectives for service standards, quality, reserving standards, expense controls and other measurable performance items.
• Perform other duties as assigned.

Qualifications:

• Bachelor’s degree or equivalent work experience.
• 3-5 years’ experience as a claim representative or equivalent.
• Excellent communication and negotiation skills.
• Strong verbal and written skills are required;

• The ability to multi-task and prioritize is needed; strong organization and time management skills required.
• Valid Georgia adjuster license and/or Georgia Certified Workers’ Compensation Professional.

• Knowledge of workers’ compensation law.
• Computer proficiency, working knowledge of Microsoft Office Products.