Claims Adjuster - Workers Compensation - Remote

Overview

The Claims Adjuster for Workers Compensation is responsible for analyzing and managing mid- and higher-level workers compensation claims, ensuring compliance with company standards and industry best practices, and negotiating settlements.

In Short

• Analyze workers compensation claims to determine benefits due.
• Ensure ongoing adjudication of claims according to standards.
• Identify subrogation of claims and negotiate settlements.
• Manage claims action plans and coordinate return-to-work efforts.
• Maintain professional relationships with clients and claimants.
• Document claim files accurately and ensure correct coding.
• Process complex medical claims involving state and physician filings.
• Support the organization's quality program.
• Work in a team environment and meet service expectations.
• Travel as required for the role.

Requirements

• Bachelor's degree preferred.
• Four years of claims management experience required.
• Knowledge of regulations and medical management practices.
• Excellent oral and written communication skills.
• PC literate, including Microsoft Office products.
• Strong analytical and interpretive skills.
• Good organizational and interpersonal skills.
• Excellent negotiation skills.
• Ability to handle work-related stress and multiple priorities.
• Ability to work in a team environment.

Benefits

• Support for mental, physical, financial, and professional needs.
• Opportunities for career growth and skill sharpening.
• Flexible work environment.
• Diversity and inclusion in the workplace.
• Recognition as a Great Place to Work®.