Claims Adjustor

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Hours between 7:30 -9:00 am 90 days Volt is immediately hiring for Medical Claims Adjustor in Egg Harbor, New Jersey (Remote) Must Live in NEW Jersey, New York or PA Medical Benefits Included As a Medical Claims Adjustor, you will: * Evaluate claimant eligibility; communicate with attending physician, employer and injured worker.

* Work with the claimant and their physician to medically manage the claim, from initial medical treatment to reviewing and evaluating ongoing medical treatment and related information.

* Work directly with employers to facilitate return to work, either on a full-time or modified duty basis.

* Confirm coverage and applicable insurance policy or coverage document and statutory requirements.

* Identify potential for third party recovery, including subrogation, Second Injury Fund or other fund involvement (when applicable) and excess or reinsurance reimbursement.

Pursue the process of reimbursement and complete posting of recovery to the claim file, where appropriate.

* Identify potential for disability or pension credits or offsets.

* Assign field adjuster investigation on potentially suspect claims.

* Ensure timely denial or payment of benefits in accordance with jurisdictional requirements.

* Establish claim reserve levels by estimating the potential exposure of each assigned claim, establish appropriate reserves with documented rationale, maintain and adjust reserves over the life of the claim to reflect changes in exposure.

* Establish compensability status through case investigation and evaluation and application of jurisdictional statutes and laws.

* Where litigation is filed, evaluate exposure and work closely with defense counsel to establish strong defenses, prepare litigation plan of action, set legal reserve and manage litigation over life of claim.

* Manage diary in accordance with Best Practices and complete tasks to ensure that cases move to the best financial outcome and timely resolution.

* Close all files as appropriate in a timely and complete manner.

* Maintain closing ratio as directed by management team.

* Oversee and coordinate medical treatment for injured employees and provide information to treating physicians regarding employees' medical history, health issues, and job requirements; provide direction to assigned nurse case manager where applicable.

* Complete PARs (payment authorization request) when applicable This is a Full-Time opportunity.

The ideal candidate will have: * Confidentiality - Possesses a high level and regard for confidentiality.

* Dependability - Is trustworthy, reliable, and accurate.

* Detail Oriented - Focuses on details to obtain a quality work product.

* Follows Direction - Acts in accordance with instructions.

* Judgment - Forms an opinion objectively and with discretion.

* Organization - Is able to plan and carry out activities effectively.

* Problem Solving - Evaluates information and situations, approaching and resolving in a timely manner.

* Teamwork - Promotes cooperation and commitment within a team to achieve goals.

* Time Management - Plans and controls time to effectively accomplish goals.

* Work Ethic - Is hard working, diligent, reliable, and has initiative.

Salary: $20.00 - $21.00 per hour Pay range offered to a successful candidate will be based on several factors, including the candidate's education, work experience, work location, specific job duties, certifications, etc.