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Adjuster - Property and Casualty Claim

Employer
Davies Claims Solutions
Location
Tulsa, Oklahoma
Salary
Salary commensurate with experience. Medical, dental, vision, 401(k), generous PTO bank and more.
Closing date
Oct 3, 2019

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Category
Claims
Job Type
Full Time
Career Level
Experienced (Non-Manager)

Job Details

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 3-5 years. 

JOB REQUIREMENTS:

  • Determines extent of insurance coverage and liability on each filed claim
  • Investigates claims, including interviewing claimants, clients and witnesses
  • Obtains necessary records/documentation, including but not limited to, hospital records, police reports, physician records, etc.
  • NMVTIS 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 and ASC billing guidelines
  • Effectively addresses and maintains incoming Docuclass documents in a consistent and timely manner
  • Attends meetings; mediations, 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 3-5 years experience in handling property and casualty claims. A college degree or equivalent business experience needed.  Experience in public school claims handling is a plus.    

Company

Davies Claims Solutions provides TPA services for a variety of insurance clients and self-insured entities including public entities and private employers with employees in many states. 

The workers’ compensation TPA claims handling process includes a number of services such as nurse case management, nurse triage, medical bill review, pharmacy benefit management, telemedicine, medical provider options, return-to-work initiatives, peer review, utilization review and more. 

 

As a TPA, we provide a number of flexible client options, such as choice of nurse case management, medical provider access with PPO networks or Alternative Cost Containment, and a choice of surveillance and claims investigation. We also offers telemedicine as a managed care solution. 

 

Our U.S. claim adjusters, have an average of 25 years of industry experience.  We have a strong track record of delivering excellent financial outcomes for our clients such as averaging indemnity savings of almost a third through our pharmacy benefit management.

 

Company info
Website
Location
2501 McGavock Pike, Suite 802
Nashville
TN
37214
US

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