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CopperPoint Insurance Companies · 2 weeks ago

Workers’ Compensation Claims Adjuster Senior, Indemnity

United States

Full-time

Remote

Mid, Senior Level

$68K/yr - $98K/yr

3+ years exp

CopperPoint Insurance Companies is a leading provider of workers’ compensation and commercial insurance solutions. They are seeking a Workers’ Compensation Claims Adjuster Senior, Indemnity to analyze and adjudicate time loss workers’ compensation claims, ensuring timely payment of benefits and proactive claims management.

Insurance

Responsibilities

Analyze and investigate indemnity claims to determine compensability decisions by interpreting and applying laws, rules, and regulations of workers’ compensation. Utilize all available resources as appropriate. Build and maintain professional relationships with injured workers, policy holders, brokers and agents through proactive claim management and timely communications. Appropriately document communications and claim management activities

Develop, maintain and adhere to action plans and reserves on indemnity claims while proactively managing claims to resolution. Establish and maintain cost drivers and data elements to ensure accurate NCCI and Medicare reporting. Proactively manage claims in accordance with company standards and statutory requirements. Ensure timely payment of indemnity and medical benefits. Actively utilize all available cost containment measures and programs

Identify settlement opportunities. Negotiate settlements with claimants and attorneys. Conducts dispute resolution with claimants and attorneys. Testify at hearings when necessary

Qualification

Arizona workers’ compensation knowledgeTechnical claims knowledgeClaims management experienceBilingual in SpanishCustomer service skillsAnalytical skillsNegotiation skillsTime management

Required

Arizona workers' compensation claims management experience is required

Strong technical workers' compensation knowledge with prior successful experience in a workers' compensation as well as other commercial lines claims management environment

Knowledge of Department of Insurance (DOI), NCCI, Department of Labor and Employment (CDLE) rules and regulations

Ability to analyze, interpret and apply laws, rules and regulations pertaining to workers' compensation

Ability to stay current with changes to statutory, industry rules and regulations as well as company policies and procedures which may impact claims management

Ability to set priorities, manage time, organize work and meet deadlines

Preferred

Additional experience in MO, KS, CO, UT, NM, NV and/or TX jurisdictions is preferred

Bachelor's degree (B. S. or B.A.) in business administration, communications, or a related field from an accredited four-year college or university is preferred

Experience/licensure in one or more of the other states in our region is highly preferred (MO, CO, UT, KS, NM, NV, OK and/or TX)

Bilingual in Spanish preferred