91 applicants

Company

SAIF Corporation · 11 hours ago

Claims Adjuster Trainee (bilingual and non-bilingual positions)

US - Oregon Remote or Hybrid

Full-time

Remote

Entry Level, Intern/New Grad

$67K/yr - $79K/yr

1+ years exp

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Comp. & Benefits

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Responsibilities

Attend and acquire knowledge through a formal training program consisting of classroom training and on-the-job training (OJT) experiences to obtain the basic skills and knowledge needed to provide claims management services. Training will provide information concerning laws, regulations, administrative rules, corporate policies and procedures and claims management systems that affect the processing of workers’ compensation claims.

Participate in OJT experiences in both compensability and disabling claims functions to apply knowledge to actual case situations. Participate in on-going training opportunities to develop skills in all aspects of claims management, benefits/benefits entitlement, and customer service.

Develop skills in evaluating claims information to determine compensability, benefit entitlements, claim reserves, and settlement parameters based on claims analysis.

Review assigned claims; develops, initiates, and follows through on plans of action. Investigates and obtains medical reports and other information required to make appropriate benefit decisions and manage claims. Ensures timely processing of claim documents based on state regulatory guidelines.

Analyze claim information, establish reserves up to a $10,000 authority limit for the ultimate probable cost, and document justification. Refer claims exceeding personal reserving authority to supervisor or designee for approval. Communicate reserve decisions to all interested parties. Re-evaluate and adjust reserves as claim exposure changes.

Establish settlement value and settle within authority from supervisor or director. Negotiate settlements with unrepresented injured workers or legal counsel.

Authorize and ensure timely and accurate payment of benefits based on applicable statute and administrative rules.

Maintain claim records and prepare claim documentation per corporate policies and standards to ensure full compliance with workers' compensation laws and rules.

Collaborate with interested parties as needed to coordinate claims management activities and claim resolution.

Visit and consult with policyholders and agents to discuss claims status and action plans.

Mitigate claims costs by referring claims with a potential for specialized cost containment services to business partners.

Manage claims issues until the claims are no longer active. Take action to resolve claims through closure or settlement and/or effects changes in benefit entitlement. Expedites resolution of litigation where possible.

Comply with the initial examiner certification requirement of successfully passing the final examination and continuing education requirements in accordance with the Oregon Administrative Rules (OARs), Chapter 436, Division 55, to ensure continued certification as a workers' compensation claims examiner.

Explore diverse perspectives and consistently behave sensitively toward differences in cultural norms, expectations, and ways of communicating. Work effectively with others who have different perspectives, backgrounds, and/or work styles.

Continually sustain the Inclusive Leadership Competencies (ILC) through the Explorer level on an annual basis.

Qualification

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Claims managementClaims examiner certificationClaims analysisInclusive leadership

Required

Strong desire to learn and to serve others.

Ability and willingness to understand customer needs.

Excellent customer service skills.

Strong work ethic.

Communication skills.

Analytical skills.

Ability to work in a fast-paced environment.

Ability to work from one of SAIF's offices or remotely from home in Oregon or Southwest Washington.

Ability to travel to one of SAIF’s offices if required.

Compliance with the initial examiner certification requirement of successfully passing the final examination and continuing education requirements in accordance with the Oregon Administrative Rules (OARs), Chapter 436, Division 55.