Workers Comp Claims Adjuster- Remote

Job Description

Junior Lost Time Claims Adjuster

This is a junior/entry level adjuster position.

Remote Position

Salary: 60k-75k, depending on experience

Job Summary

The Junior Lost Time Adjuster determines the extent and legitimacy of claims and issue 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.

Required:

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

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.

Must meet minimum qualifications. NO Exceptions.