Job Description
We are seeking a skilled Workers Compensation Claims Adjuster II. The ideal candidate will have a strong background in handling complex workers' compensation claims, demonstrating expertise in investigation, evaluation, negotiation, and settlement.
Job description
- Perform a three-point contact on all new losses within 24 hours of receipt of the claim to include the claimant, employer, and treating physician to document relevant facts surrounding the incident itself as well as disability and treatment status.
- Thoroughly and accurately gather evidence regarding ongoing case facts and relevant information necessary for establishing compensability, the need for disability payments, the use of vendors, medical and expense payments, and the reason the claim is still open.
- Assure that all assigned indemnity claims have an up-to-date plan of action outlining activities and actions anticipated for ultimately resolving the claim.
- Form a partnership with the medical case manager to maximize early return to work potential thereby reducing the need for extended disability payments, vocational rehabilitation, and other protracted claims costs.
- Initiate the referral to the SIU of cases with suspected fraud.
- Aggressively pursue subrogation from culpable third parties, contributions on multiple defendant cases, and apportionment when there is pre-existing disability.
Salary
$80 - $85K+ (based on experience)
Requirements
- 3-5+ years’ experience
- Bachelor’s degree or at least 5-7 years related experience and / or training; or equivalent combination of education and experience
- Possess an SIP certificate.
LI-MM4
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