Claims Adjuster II Workers' Compensation - IL, MO, KS
General Summary:
The Claims Adjuster II is responsible for timely and accurate management of workers' compensation claims with moderate medical and indemnity benefit exposure, including litigation.
Essential Duties and Responsibilities:
- Completes initial contacts to obtain necessary additional information, verify coverage, determine compensability and develop of plan of action. Completes and maintains accurate claim system data.
- Analyzes case facts to establish timely and accurate case reserves using knowledge of medical disabilities and related costs, as well as judgment of extent of disability.
- Provides timely and appropriate customer service within established best practices. Maintains ongoing professional communications with all internal and external customers.
- Accurately evaluates and pays benefits in compliance with statutory and company procedures and guidelines. Files appropriate state forms, as needed.
- Proactively coordinates and monitors medical treatment to continue to move the claim forward. Uses resources, internal and external, to contain costs and manage exposure.
- Reviews and analyzes legal exposures. Collaborates with defense attorneys to manage legal issues. Proactively mitigates exposure to litigation, prices up claims for settlement and works within authority to resolve claims.
- Regularly reviews caseload and proactively takes action to guide claims efficiently and effectively to closure.
- Other duties may be assigned.
Job Requirements:
- Excellent communication and customer service skills and knowledge of an imaged environment.
- Demonstrated knowledge of workers' compensation laws and ability to adhere to statutes, regulations and company policies and practices, as well as related claim management procedures/protocols.
- Two to five years claims adjusting or insurance experience.
- Self-motivated with excellent analytical, problem solving and decision-making skills. Strong ability to multi-task and prioritize.
- If state certification or license is required, must meet requirements and obtain certification within state mandated timeframe and maintain any required license through continuing education.
- Must have High School Diploma or GED equivalent.
Preferred but not required:
- Bachelor's degree or equivalent business experience preferred.
- WCCP, AIC, ARM, CPCU or other insurance certification a plus.
- An equivalent combination of education and experience may be substituted for the requirements listed above.
Work Environment
This position is required to be in-office full time with minimal travel to other office locations/meeting locations occasionally. This role potentially and will routinely use office equipment such as computers, phones, printers, and web conferencing technology as examples.
- This is largely a sedentary role; however, some mobility is required.
- May work early, late, or occasional weekend hours to accommodate business needs.
- Occasional lifting of a maximum of 30lbs.
- Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Salary: $53,000- $75,000 + Comprehensive benefits package and bonus opportunity, please follow the link to our benefits page for details!
About EMPLOYERS
EMPLOYERS is a dynamic, fast-growing provider of workers' compensation insurance and services, we are seeking a goal-oriented individual willing to put their ideas to work!
We offer a positive, challenging work environment, combined with an opportunity to build your career as you help us grow our business, in innovative and imaginative ways that are uniquely EMPLOYERS !
Headquartered in Nevada, EMPLOYERS attributes its long-standing success to its most valuable resource, our employees across the United States. EMPLOYERS is known for the quality service and expertise we provide to our clients, and the exemplary work environment we provide for our employees.
We live and breathe our core values: Integrity, Customer Focus, Collaboration, Initiative, Accountability, Innovation, and Personal Fulfillment. These are the pillars that support how we do business with our clients as well as how we treat each other!
At EMPLOYERS, you'll discover an energetic environment that inspires top achievement. As "America's small business insurance specialist", we have the resources, a solid reputation and an expanding nationwide identity to enrich your work/life and enhance your career.
Compensation details: 0
PI631adb320af2-2867
