Apply on Employer Site

Midwestern Insurance Alliance · 1 month ago

Workers' Compensation Claims Adjuster - REMOTE

United States

Full-time

Remote

Mid, Senior Level

$80K/yr - $85K/yr

3+ years exp

Midwestern Insurance Alliance (MIA) is seeking a full-time Remote Claims Adjuster to join its worker’s compensation claims processing team. The role involves investigating claims, ensuring their validity, and managing medical payments and reserves throughout the claims process.

BankingFinanceInsurance

Responsibilities

Thoroughly investigating worker’s compensation claims by contacting injured workers, medical providers, and employer representatives

Determining if claims are valid under applicable worker’s comp statutes

Communicating with medical providers to develop and authorize appropriate treatment plans

Reviewing and analyzing medical bills to confirm charges and treatment are worker’s comp injury-related and in accordance with the treatment plan

Ensuring payments for medical bills and income replacement are remitted on a timely basis in accordance with applicable fee schedules and statutes

Calculating and assigning appropriate reserves to claims, and managing reserve adequacy throughout the life of the claim

Managing claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries, and Social Security and Medicare offsets

Preparing required state filings within statutory limits

Providing information as needed for litigation or settlement negotiations

Qualification

WC claims adjusting experienceWC Claims Adjuster licenseGeorgia WC claims experienceFlorida WC claims experienceMS Word proficiencyMS Excel proficiencyMS Outlook proficiencyManage multiple tasksCommunication skillsOrganizational skillsWork independently