Claim Adjuster licenses

Job Description :

"3+ years of Workers’ Compensation Lost Time Claim Examiner or Commensurate Experience (Having experience in worker’s compensation is not a requirement but a nice thing to have, as long as the skills they do have are transferable.)

Duties and Responsibilities :

• Handles all aspects of workers’ compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process.
• Reviews claim and policy information to provide background for investigation.
• Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with insured, claimant and medical providers.
• Evaluates the facts gathered through the investigation to determine compensability of the claim.
• Informs insureds, claimants and attorneys of claim denials when applicable.
• Prepares reports on investigation, settlements, denials of claims and evaluations of involved parties, etc.
• Timely administration of statutory medical and indemnity benefits throughout the life of the claim.
• Sets reserves within authority limits for medical, indemnity and expenses and recommends reserve changes to Team

Leader throughout the life of the claim.

Consultants, Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service.

Technical Skills & Competencies :

Experience, Education & Requirements :