Claim Adjuster - Workers Compensation
Investigates and evaluates workers compensation losses while developing a plan of action to bring claims to proper resolution in a timely manner. Experience level preferably between 3 - 5 years.
- Determines extent of insurance coverage and compensability for new claims and pensioner claims
- Investigates claims, including interviewing employees, employers, witnesses
- Obtains necessary records, including but not limited to, hospital records, police reports, physician records, etc.
- Utilizes appropriate preferred vendors
- Monitors/directs medical treatment
- Handles Medicare subrogation issues
- Presents thorough and accurate reports to clients
- 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
- 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
- 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
- Will work onsite at local office as well as onsite with client
Should have 3 - 5 years experience in handling either workers’ compensation claims. A college degree or equivalent business experience needed.