Liability Claims Adjuster III

Job Description

Job Description

Liability Claims Adjuster III

Remote Worker – N / A

Description

Summary :

This is a dynamic claims and account management position. In accordance with applicable statutes and in keeping with company rules, regulations, client guidelines and established performance objectives, this role is responsible for effectively managing to conclusion an assigned inventory of medical professional and general liability claim files that may include cases of extreme complexity or with unique or unusual issues.

This position is multifaceted and includes the following primary areas of focus :

Culture  – Every member of the Intercare team is responsible for nurturing and promoting a healthy culture. Our culture is the most important element of our success. Intercare’s culture is defined by our Core Values :

• INTEGRITY :  Reinforces our commitment to transparency
• COLLABORATION :  Strengthens our passion for customer service
• ACCOUNTABILITY :  Supports our actions
• RESPECT :  Inspires us to do the right thing
• EXCELLENCE :  Drives our outcomes

Claims Management  – This teammate will be directly responsible for claim and account management. Expectations regarding claim and account management are best described by our mission :

Mission :  To be the leading third-party administrator offering professional and technological resources through proactive and aggressive claims, risk and managed care solutions in support of our clients’ objectives. Innovative processes and state-of-the-art technology support our people. Exceptional individuals provide the human element needed to deliver excellent service and drive excellent outcomes.

Quality  – The leader works closely with every member of the Intercare team to carry out our vision to promote growth :

Vision :  To be recognized as the most trusted and innovative partner in providing Claims and Managed Care solutions that are tailored to the specific needs of our clients.

Essential Duties and Responsibilities :

Competency :

To perform the job successfully, an individual should demonstrate the following :

Qualification Requirements :

To perform this job successfully, an individual must, at a minimum, be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and / or Experience :

JD and / or RN preferred. Bachelor’s degree from a four-year college or university; at least seven years of related experience and / or training; or an equivalent combination of education and experience. Requires a high degree of claims handling expertise, including at least five years managing medical professional liability cases, many with complex litigation or high potential value.

Language Skills :

Ability to read, analyze and interpret insurance policies, statutes, legal opinions, business periodicals, professional journals, technical procedures and governmental regulations. Ability to write complex coverage letters, reports, business correspondence, procedure manuals and correspondence to clients, colleagues and industry peers. Ability to effectively present information verbally and in writing and respond to questions from groups of managers, clients, customers and the general public. Fluent spoken and written English is required.

Math Skills :

Ability to add, subtract, multiply and divide in all units of measure using whole numbers, common fractions and decimals. Ability to compute rate, ratio and percent and to draw and interpret bar graphs.

Reasoning Ability :

Requires strong problem-solving and analytical skills. Ability to apply common-sense understanding to carry out instructions in written, oral or diagram form, and to deal with problems involving several concrete variables in standardized situations.

Computer Skills :

Proficiency in Word, Excel, Outlook, PowerPoint, RMIS software, RingCentral, Zoom, TEAMS, WebEx, GoToMeeting and other tele-video conferencing software and apps.

Certificates and Licenses :

JD and / or RN licensure preferred. Appropriate jurisdictional adjuster license required.

Physical Demands :

The physical demands described here are representative of those that must be met to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions.

Work Environment :

The work environment characteristics described here are representative of those encountered while performing essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform these functions. The noise level in the work environment is usually moderate.

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