Workers Compensation Claims Adjuster III

Job Description

Seeking an experienced and detail-oriented Senior Workers' Compensation Claims Adjuster. The ideal candidate will have a thorough understanding of workers' compensation laws and regulations, and a proven track record of managing complex claims from inception to resolution. This role involves investigating, evaluating, and negotiating settlements for workers' compensation claims, ensuring compliance with legal requirements, and providing exceptional customer service to claimants and employers.

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 document ongoing case facts and relevant information necessary for establishing compensability, the need for disability payments, the use of vendors, medical and expense payments, and what is being done to move the case toward closure.
• 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.
  
  

Salary

$80k-95K/Yearly

Requirements

• 5 years’ experience
• SIP and City/County experience preferred