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Occupational Claims Adjuster


Position
Summary:
Professionally handle all financial, medical, vocational and legal aspects of workers' compensation claims of associates with consideration of departmental/company standards, individual state guidelines and insurance industry best practices. Strategically manages available resources to achieve best claims outcomes at the lowest cost.
Principle Duties & Responsibilities:
o Provides professional, technical guidance for the management of workers' compensation claims using regulatory knowledge, familiarity of Company policies and Human Resource practices.
o Conducts investigations on assigned claims, creates action plans for resolution, evaluates financial exposure and sets appropriate reserves.
o Provides direction, advice and support to Company associates and all levels of management on the technical aspects of workers' compensation management in a cost effective manner.
o Analyzes compensability based on individual state workers' compensation laws, Company claims standards and their knowledge/experience in the handling of W/C claims.
o Assigns and directs outside resources including attorneys, rehabilitation counselors and investigators whole developing partnerships to maximize efficiency.
o Manages medical treatment of associates and develops relationship with providers to ensure cost effective and best available treatment plans.
o Coordinates with other internal departments to provide the accurate payroll information, availability of alternate work duties and securing appropriate legal documentation.
o Effectively communicates with local management and outside professionals.
o Maintains confidentiality of information and records.
Basic Qualifications:
o Licensed adjuster (as appropriate by jurisdiction) or qualified to sit for licensing exam following at least I year in house training.
o Bachelor's degree.
o Minimum of 3 years' experience handling large caseload of workers' compensation claims.
o Working knowledge of office computer software including MS Outlook, Word, Excel and others as required.
o Familiarity with reading, reviewing and interpreting medical records.
Preferred Qualifications:
o Experience in risk management, self-administered programs and/or insurance matters.
o Excellent interpersonal skills.
o Ability to multi-task.
o Negotiation skills.
o Ability to work in a team environment.
o Telephone skills.

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