Claims Adjuster, Worker's Compensation
Core
Manage the full lifecycle of workers' compensation claims for small businesses, ensuring regulatory compliance and favorable outcomes.
Role type
Claims Adjuster (Workers' Compensation)
Builds
Claim files and customer service experiences for small business clients
Domain
Insurance / Workers' Compensation
Deliverable
client delivery
Required skills
Workers' compensation claims adjudication, claim mitigation, reserve setting, statutory compliance, medical management, litigation management, settlement negotiation
Preferred skills
G-Suite tools, Slack, CMS/MSA requirements knowledge
Technologies
G-Suite, Slack
Responsibilities
Independently handle all aspects of workers' compensation claims from set-up to closure; Conduct timely 3-point contact investigations; Mitigate claim exposure while achieving the best outcome; Determine timely and accurate compensability decisions; Set and adjust timely/accurate reserves; Administer statutory medical and indemnity benefits; Control legal activity with defense counsel; Prioritize early resolution opportunities and negotiate settlement; Serve as a point of contact for agents and customers; Provide claim status, coverage verification, and loss run reports; Continuously improve claims operations and processes