Workers Comp Claims Adjuster

Remote Position

Salary: 65k-80k, commensurate with experience

Illinois experience is required

Job Summary

The Workers Comp Claims Adjuster determines the extent and legitimacy of claims and issues benefits as jurisdictionally required.

Responsibilities:

• Responsible for prompt and pro-active management of medical only claims from time of receipt to conclusion of claim to ensure timely, fair, and cost-effective resolutions. This includes timely contacts with insureds, claimants, and medical providers; making compensability determinations; paying wage loss benefits; issuing jurisdictional appropriate forms and EDI transactions; evaluating injuries and treatment plans.
• Properly reserves funds. Adjusts reserves timely and appropriately as the facts of the claim change.
• Reviews and maintains claim system diaries.
• Properly documents files to support decisions and actions taken pursuant to applicable Best Practices.
• Follows company policies and procedures with respect to all essential duties and responsibilities of the job.
• Follows client specific special handling instructions.
• Effectively communicates in a professional manner both verbally and written.
• Prepares claim summaries and attends claim reviews and client meetings as needed.
• Other duties as assigned. 

Qualifications:

• College degree preferred.
• One year related claims experience is a plus.
• Extensive knowledge of accepted industry standards and practices Computer experience with related claims and business software.
• Illinois experience is required.

 

Work Traits:

 

· Ability to think critically, solve problems, plan, and organize activities, serve clients, negotiate, effectively communicate verbally and in writing and embrace new challenges.

· Analytical skill necessary to make decisions and resolve complex issues inherent in handling losses.

· Ability to successfully negotiate the settlement and disposition of serious claims including the ability to interpret related documentation.

 

Eligibility Requirements:

· Interested candidates must submit a resume/online to be considered

· Must be willing to submit to a background investigation; any offer of employment is conditioned upon the successful completion of a background investigation

· Must be willing to execute Employee Agreement or Confidentiality/Non-Disclosure Agreement which requires, among other things, post-employment obligations relating to non-solicitation, confidentiality, and non-disclosure

We offer a competitive salary plus benefits.

Posted On: Tuesday, June 11, 2024