EMPLOYERS · 17 hours ago
Claims Adjuster II | Midwest
United States
Full-time
Remote
Entry, Mid Level
$50K/yr - $75K/yr
2+ years expEMPLOYERS is a dynamic provider of workers' compensation insurance and services, seeking a goal-oriented Claims Adjuster II. This role is responsible for the timely and accurate management of workers’ compensation claims, including customer service, case analysis, and legal collaboration.
FinanceFinancial ServicesInsurance
No H1B
Responsibilities
Completes initial contacts to obtain necessary additional information, verify coverage, determine compensability and develop of plan of action. Completes and maintains accurate claim system data as it pertains to work comp insurance claims
Analyzes case facts to establish timely and accurate case reserves using knowledge of medical disabilities and related costs, as well as judgment of extent of disability
Provides timely and appropriate customer service within established best practices. Maintains ongoing professional communications with all internal and external customers
Accurately evaluates and pays benefits in compliance with statutory and company procedures and guidelines. Files appropriate state forms, as needed
Proactively coordinates and monitors medical treatment to continue to move the claim forward. Uses resources, internal and external, to contain costs and manage exposure
Reviews and analyzes legal exposures. Collaborates with defense attorneys to manage legal issues. Proactively mitigates exposure to litigation, prices up claims for settlement and works within authority to resolve claims
Regularly reviews caseload and proactively takes action to guide claims efficiently and effectively to closure
Other duties as assigned
Qualification
Required
2 - 5 years' work comp claims adjusting or insurance experience
3 years experience managing work comp claims at a high level (compensability and claim reopening investigation skills, accurate benefit calculation and delivery, accurate claim reserving, proactive medical management, litigation avoidance and negotiation skills)
Ability and willingness to manage additional jurisdictions as needed
Excellent communication and customer service skills and knowledge of an imaged environment
Demonstrated knowledge of workers' compensation laws and ability to adhere to statutes, regulations and company policies and practices, as well as related claim management procedures/protocols
Self-motivated with excellent analytical, problem solving and decision-making skills. Strong ability to multi-task and prioritize
High school diploma or equivalent required
Equivalent combinations of education and experience may be considered
If state certification or license is required, must meet requirements and obtain certification within state mandated timeframe and maintain any required license through continuing education
Preferred
WCCP, AIC, ARM, CPCU or other insurance certification preferred
Bachelor's degree or equivalent business experience preferred
Benefits
Strong comprehensive benefits package
Company
EMPLOYERS
Employers is a provider of workers' compensation insurance for small businesses.
501-1000 employees
Funding
Current Stage
Public CompanyTotal Funding
unknown2007-01-31IPO
Leadership Team
Mark Law
VP, Digital Products and Innovation
Recent News
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