Claims Adjuster - Workers Compensation - Remote

Overview

The Claims Adjuster for Workers Compensation will analyze mid- and higher-level claims to determine benefits due, ensuring ongoing adjudication of claims while identifying subrogation and negotiating settlements.

In Short

• Analyze workers compensation claims to determine benefits due.
• Ensure claims are adjudicated within company standards.
• Identify subrogation of claims and negotiate settlements.
• Manage long-term indemnity claims and monitor reserve accuracy.
• Develop action plans for claims resolution.
• Communicate claim actions with claimants and clients.
• Maintain proper documentation and claims coding.
• May process complex medical claims.
• Support the organization's quality programs.
• Travel as required.

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 organizational and analytical skills.
• Good interpersonal and negotiation skills.
• Able to work in a team environment.
• Ability to meet or exceed service expectations.
• Ability to handle multiple priorities and work-related stress.

Benefits

• Comprehensive benefits package including medical, dental, and vision.
• 401k and matching.
• PTO and disability insurance.
• Employee assistance programs.
• Flexible spending or health savings account.
• Additional voluntary benefits.
• Great workplace culture recognized by various awards.
• Opportunities for career growth.
• Inclusive and diverse workplace.
• Work-life balance.