Claims Adjuster - Workers Compensation

Claims Adjuster - Workers Compensation

Remote with experience in CO/AZ

3 Months - Contract

Note: Claims adjuster with experience in CO/AZ

PRIMARY PURPOSE: To process low level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements with general supervision.

Experience : Two (2) years of claims management experience or equivalent combination of education and experience or successful completion of Claims Representative training required.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

Processes low level workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency.

Develops and coordinates low level workers compensation claims' action plans to resolution, return-to-work efforts, and approves claim payments.

Approves and processes assigned claims, determines benefits due, and administers action plan pursuant to the claim or client contract.

Administers subrogation of claims and negotiates settlements.

Communicates claim action with claimant and client.

Ensures claim files are properly documented and claims coding is correct.

May process low-level lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review.

Maintains professional client relationships.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

Performs other duties as assigned.

Supports the organization's quality program(s).

Travels as required.