Lost Time WC Claims Adjuster

LOST TIME WC CLAIMS ADJUSTER POSITION DESCRIPTION:

 

In the role of Lost Time Claims Adjuster for Workers' Compensation, you will be essential in managing claims efficiently while providing outstanding customer service. Reporting to the Claims Manager, you will utilize your core skills in negotiation and analysis to assess claims and ensure compliance with workers' compensation laws. As a Lost Time Claims Adjuster, you will be investigating claims, determining if the claim is payable and managing the care of the injured employee.

Attributes include:

• Ability to solve practical problems and to work independently.
• 5+ years of Workers Compensation Claims handling. Lost Time adjusting for at least 3 years.
• Ability to be resourceful and prioritize.
• Good interpersonal skills.
• Ability to build and maintain relationships with insureds, injured workers and attorneys.
• Fluent English is required. Spanish speaking is a plus.

The position involves:

• Determining coverage on new claims.
• Contacting employer for initial investigation.
• Contacting employee/injured worker for information – recorded statements
• Reviewing medical bills to determine if payment is proper and referral of those bills for audit.
• Filing necessary forms with the Industrial Commission.
• Determining appropriate reserves for claims.
• Determining when claims need medical case management services and arranging the necessary care.
• Corresponding with attorneys on legal issues.
• Attending mediations and hearings.

Preferred states for claims handling: NC, SC, GA, KY, TN