Claims Adjuster
- Employer
- Davies Claims Solutions
- Location
- Nashville, Tennessee
- Salary
- Not specified
- Closing date
- Mar 20, 2021
View more
- Category
- Claims
- Job Type
- Full Time
- Career Level
- Experienced (Non-Manager)
Job Details
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 compensability for new claims,
presumption 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
Required Experience:
Should have 3 - 5 years experience in handling workers’ compensation claims. A college degree or equivalent business experience needed.
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.
- Website
- http://www.ascrisk.com/
- Location
-
2501 McGavock Pike, Suite 802
Nashville
TN
37214
US
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