Insurance Program Managers Group · 3 weeks ago
Senior Workers' Compensation Lost Time Claims Adjuster
St. Charles, IL, US
Full-time
Onsite
Senior Level
$85K/yr - $90K/yr
5+ years expInsurance Program Managers Group (IPMG) is seeking a driven and energetic Senior Workers' Compensation Lost Time Claims Adjuster to join their dynamic team. The role involves performing technical work on intermediate to complex workers’ compensation claims, ensuring thorough investigations, maintaining timely communication with all parties involved, and managing claims effectively.
Financial ServicesInsurance
Responsibilities
Follows defined processes, quality standards and procedures are followed
Ensure contact with insured, claimant, witnesses, doctors and other parties are secured and obtain details about the loss and properly investigate if claims are compensable while using investigative approach in decision making for approval or denial
Reviews all new claims within 1-2 business days
Reviews claim related correspondences and determine appropriate actions are made
Maintains files notes in accordance with established procedures, maintains timely diary management, updates accurate coding and claim closing goals
Provides timely and proactive information to clients, claimants, insureds, and others regarding the status of claims
Recognizes clients that participate in occupational health structures with compliance to their respective special protocols
Sets initial and on-going reserves for incurred costs and authorizes or denies payments based on facts of the claim
Ensures subrogation opportunities are consistently identified and executed with correct outline for accurate recovery
Draft coverage letters and discuss outcomes with clients and agents proactively before letter is sent
Properly evaluate exposure report to excess carriers and reinsurers accordingly
Roundtable claims with management and counsel, as needed
Efficiently manage vendor related costs while assigning the correct vendor based on service need
Maintain current weekly diary with limited overdue items
Where appropriate effectively negotiates using negotiation tactics for settlements
Executes on 90-day interface claim reviews with quality and timeliness as prescribed by client’s service plan
Communicate effectively with all internal and external business partners using all forms of communication to obtain timely contact
Written and verbal communication is professional and timely
Communicate effectively by expressing oneself in a clear and concise manner in one-one and group discussions while listening attentively in collaborative discussions
Foster a sense of energy, urgency, ownership, and personal commitment to work
Participation and coordination in client claim reviews and/or teleconferences
Occasional travel to clients for claim reviews where warranted
Promotes culture of collaboration and teamwork across all organizational boundaries
Recognizes clients that participate in occupational health structures with compliance to their respective special protocols
Analyzes the nature of the loss, compensability, and scope of the injury for adequate reserving and actions needed to move claim forward
Utilizes Nurse Case Management as needed for complex claims
Works with defense council regarding questionable compensability scenarios and IME doctor selection
Maintain Medicare screens to meet Section 111 requirements
Ensure qualifying cases have Medicare Set Aside
Well versed in multiple jurisdictions
Qualification
Required
At least 5 years of adjuster experience
Knowledge of common software programs such as Microsoft Office and Excel
Excellent verbal and written communication skills
Great customer service skills
Benefits
IPMG offers a Year End Bonus to qualified employees
20 days of PTO each year.
2025 includes 13 paid holidays and YOUR BIRTHDAY OFF!
Medical, dental, and vision coverage on day one of full-time employment.
Telemedicine is free for you and your family (day one) if you are covered under our medical plan.
401k match.
Professional development support and a Linkedin Learning subscription.
Flexible time off with an encouraged time away to support a healthy work-life balance.
Life Insurance, Short term, and long-term disability on day one of full-time employment and paid for by IPMG.
Onsite fitness center and showers, in our St. Charles, IL HQ office.
Company
Insurance Program Managers Group
At IPMG, we are committed to helping independent agents/brokers and their clients thrive by delivering superlative products and services that can bring transformative change.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Gregg Peterson
President/CEO
Matt Reed
CFO
Company data provided by crunchbase