Work Comp Claims Adjuster
Workers Compensation Claims Investigator Looking for someone with wage loss experience in the states of IL/MI/IN. This position has the ability to work remotely. Summary: Under general supervision and following standard procedures with independent judgment, investigates, evaluates and resolves/disposes of workers compensation claims to determine the extent of company liability; may include determination and evaluation of coverage, compensability, and liability in accordance with policy provisions by performing the following duties. Essential Duties and Responsibilities:
- Follows corporate policies, procedures, and fair claims handling practices
- Investigates claims to determine validity and extent of liability, including:
- Obtains information necessary to properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses and others
- Reviews and evaluates documentation, including applications, reports, and statements
- Monitors appropriate claim outcomes through self-audit process
- Delivers superior customer service to policyholders and agents, ensuring appropriate and timely resolution of claims service issues
- Ensures legal, regulatory and fair claims handling compliance
- Sets or recommends reserves based on results of claim investigation.
- Within defined authority, manages, evaluates and concludes claims. Prepares and maintains claim reports.
- May provide extensive interaction with insureds, agents, claimants, attorneys, and other service providers, including:
- Conducts in-depth interviews and/or scene inspections
- Attends settlement conferences and/or trials
- May serve as a member of project teams, contributing to the achievement of project objectives.
- Performs other duties as assigned.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Education/Experience: Level 4: Two to four years related experience and/or training; or associate's degree (A.A.) from two-year college/technical school; or equivalent combination of education and related experience/training. A minimum requirement for this position is the ability to work legally in the United States. No visa sponsorship/support is available for this position, including for any type of U.S. permanent residency (green card) process. Apply tot his job Apply To this Job