Sr. Workers Compensation Claims Adjuster

Job Description

Salary: $60,000-$80,000

Company Overview:

Location:Galloway, New Jersey (remote, hybrid, and on-site options)

Industry:Third-party administrator (TPA) managing multi-line claims for both private sector and public entities in NJ, PA, DE, and NY

Values:Client-focused, ethical, relationship-based

Job Summary:

Role:Sr. Workers' Compensation Claims Adjuster - 7+ Years of Experience

Responsibilities:Evaluation, investigation, and resolution of claims in NJ, PA, and/or DE

Key Skills:Effective investigation, coordination of medical care, negotiation, and interaction with various stakeholders

Duties/Responsibilities:

Claims InvestigationFrom basic to complex medical and indemnity files

Compensability Determinations:Timely and jurisdictionally compliant

Documentation:Action plans, reserves, insurance coverage, and client self-insured retention

Fraud Detection:Identify and notify management

Medical Management:Treatment coordination, pre-authorization, and bill approval

Indemnity Benefits:Calculation and timely payment

Negotiation:Settlements within authority and award payments

Communication:Effective verbal and written communication with internal and external parties

Requirements and Qualifications:

Education:Associate's degree or equivalent work experience; bachelor's degree preferred

Experience:7+ years in workers' compensation claims; public entity experience is a plus

Skills:Detail-oriented, strong customer service, proficient in Internet and Microsoft Office, strong communication, interpersonal, analytical, investigative, and negotiation skills

Licenses:Maintains insurance adjuster licenses as required

Physical Requirements:

Work Environment:Prolonged periods of sitting and computer work

Growth and Development:

Learning Approach:Lifelong learning with tools and training for success

Employee Benefits:

Comprehensive Package:Paid time off, medical, dental, vision, 401k, LTD, STD, HRA, FSA, and Group Life Insurance

Equal Opportunity Employer:

Inclusivity:Employment opportunities for all qualified individuals regardless of various protected characteristics

Flexibility:

Job Description:Subject to change with or without notice

Employee Benefits:

The well-being of our employees is important to us. We offer a comprehensive benefits package including paid time off, medical, dental, vision, 401k, LTD, STD, HRA, FSA, and Group Life Insurance.

If you meet the above requirements and want to join a high-performing team, please forward your resume for consideration.

Claims Resolution Corporation, Inc. is an Equal Opportunity Employer, providing employment opportunities to all qualified individuals regardless of race, creed, color, sex, sexual orientation, religion, national origin, age, disability, or any other basis prohibited by law.

This job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice.

remote work

Hybrid remote