Position: Sr. Workers Compensation Claims Adjuster (CO Jurisdiction)
Salary: $80,000 to $90,000 (depending on experience)
Type: Hybrid
DUTIES AND RESPONSIBILITIES:
- Effectively manages an active caseload of 150 workers’ compensation files, including medical only, indemnity, lifetime medical and permanent partial benefit claims.*
- Initiates and conducts claims investigation in a timely manner.*
- Determines compensability of claims and administer benefits, based upon state law and in accordance with established Company guidelines.*
- Manages medical treatment and medical billing, authorizing as appropriate.*
- Communicates with claimants, providers and vendors regarding claims issues.*
- Computes and set reserves within Company guidelines.
- Maintains diary system for case review and document file to reflect the status and work being performed on the file.*
- Communicates appropriate information promptly to the client to resolve claims efficiently, including any injury trends or other safety related concerns.*
- Adheres to all Company policies and procedures.*
- Participates in file reviews with clients, as needed.
- Other duties as assigned and including claims management of other jurisdictional workers’ comp claims.
*Essential job function.
EQUIPMENT OPERATED/USED: Computer, 10-key, fax machine, copier, printer and other office equipment.
SPECIAL EQUIPMENT OR CLOTHING: Appropriate office attire.
QUALIFICATIONS REQUIRED:
Education/Experience: High School Diploma or GED required; Bachelor’s degree in related field (preferred); and two (2) years related experience (preferred); or equivalent combination of education and experience.
Knowledge, Skills and Abilities:
- Analytical skills.
- Excellent written and verbal communication skills, including ability to convey technical details to claimants, clients and staff.
- Ability to interact with persons at all levels in the business environment.
- Proficient in Word and Excel (preferred).