Claims Adjuster - Workers Compensation

Iconma

Las Vegas, NV

JOB DETAILS
SKILLS
Adjudication, Analysis Skills, Applications Security, Auditory, Best Practices, Business Solutions, Claims Coding, Claims Management, Claims Processing, Compensation and Benefits, Computer Skills, Customer Relations, Develop and Maintain Customers, Documentation, Health Plan, Identify Issues, Industry Standards, Medical Treatment, Medicare, Microsoft Office, Microsoft Product Family, Multitasking, Negotiation Skills, Organizational Skills, People Management, Presentation/Verbal Skills, Problem Solving Skills, Regulations, Subrogation, Team Player, Time Management, Utilization Management, Worker's Compensation, Writing Skills
LOCATION
Las Vegas, NV
POSTED
8 days ago
Our Client, a Business Solutions company, is looking for a Claims Adjuster - Workers Compensation for their Las Vegas, NV/Remote location.
 
Responsibilities:
  • To analyze mid- and higher-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.
  • Manages 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 manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
  • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
  • Manages 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 complex 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.
 
Requirements:
  • Bachelor's degree from an accredited college or university preferred.
  • Four (4) years of claims management experience or equivalent combination of education and experience required.
  • Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business
  • Excellent oral and written communication, including presentation skills
  • PC literate, including Microsoft Office products
  • Analytical and interpretive skills
  • Strong organizational skill
  • Good interpersonal skills
  • Excellent negotiation skills
  • Ability to work in a team environment
  • Ability to meet or exceed Service Expectations
  • When applicable and appropriate, consideration will be given to reasonable accommodations.
  • Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines
  • Physical: Computer keyboarding
  • Auditory/Visual: Hearing, vision and talking
 
Why Should You Apply?
  • Health Benefits
  • Referral Program
  • Excellent growth and advancement opportunities
 
ICONMA is an Equal Opportunity Employer. All qualified applicants will receive considerationfor employment without regard to any status protected by applicable law.
 

About the Company

I

Iconma

ICONMA is a global information consulting management firm providing Professional Staffing Services and Project-Based Solutions for organizations in a broad range of industries.

  • Corporate Headquarters in Troy, Michigan; 20+ locations worldwide.
  • Certified Woman-Owned Business Enterprise (WBE); certified by Women’s Business Enterprise National Council, National Women Business Owners Corporation (NWBOC); and California Public Utilities Commission (CPUC).
  • Founded in 2000
  • 2000+ Employees

The company was founded on the principle that success is derived from delivering high quality service and resources in the most responsive, flexible, and innovative way. ICONMA invests in people and resources with a single goal: To provide our customers with the highest quality service in the most responsive manner. Through its network of offices, ICONMA provides the resources to help clients maintain their competitive advantage.

COMPANY SIZE
2,000 to 2,499 employees
INDUSTRY
Management Consulting Services
EMPLOYEE BENEFITS
401K, Employee Referral Program, Life Insurance
FOUNDED
2000
WEBSITE
https://www.iconma.com/