WC Claim Adjuster

Location
Irving, Texas
Salary
Salary commensurate with experience. Medical, dental, vision, 401(k), generous PTO bank and more.
Posted
Sep 13, 2019
Closes
Nov 12, 2019
Category
Claims
Job Type
Full Time

SUMMARY

Workers Comp  Adjuster investigates and analyzes claims. Determines coverage and negotiates settlement with claimants.  Minimum experience level should be between 3-5 years.

 

JOB REQUIREMENTS:

 

  • Determines extent of insurance coverage and compensability on each filed claim
  • Investigates claims, including interviewing employees, employers, witnesses
  • Obtains necessary records, including but not limited to, hospital records, police reports, physician records, etc.
  • Utilizes appropriate vendor for medical bill review
  • Presents thorough and accurate reports to clients and excess carriers on claims investigations/situations
  • Negotiates settlements for resolutions with claimants and their attorneys
  • 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
  • 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 operate a personal computer using standard or customized software applications appropriate to assigned tasks
  • Ability to prepare and present accurate and reliable reports containing finding and 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
  • 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

Required Experience:

 

Should have minimum of 3-5 years of experience in handling workers’ compensation claims. A college degree or equivalent business experience needed.  Texas Non-Subscribers claims handling is a plus.

 

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