Sr Workers Compensation Claims Adjuster
Sr Workers Compensation Claims Adjuster
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1 Vacancy
Job Description
About Acrisure:
Acrisure is a global Fintech leader that combines the best of humans and high tech to offer multiple financial products and services to millions of businesses and individual clients. We connect clients to solutions that help them protect and grow what matters including Insurance Reinsurance Cyber Services Mortgage Origination and more.
Acrisure employs over 17000 entrepreneurial colleagues in 21 countries and have grown from $38 million to $4.3 billion in revenue in just over ten years. Our culture is defined by our entrepreneurial spirit and all that comes with it: innovation client centricity and an indomitable will to win.
Job Summary:
The Workers Compensation Claims Adjuster must be knowledgeable of California laws and administration of claims.
It is the responsibility of a Workers Compensation Claims Adjuster to receive and organize all documents related to the employee and the injury to make a determination regarding the claim. The Claims Adjuster is responsible for the prompt and efficient examination and investigation of claims. Workers Compensation Claims Adjusters abide by company guidelines when making claim determinations.
This role requires excellent communication and customer service skills strong motivation and organizational skills.
Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Responsibilities:
Assess coverage and review claims for purposes of investigations action plans evaluation fraud and claim resolution.
Complete quality investigations by gathering pertinent information. Reviews and evaluates coverage and/or liability. Secures necessary information (i.e. reports policies releases statements or other documents) in the investigation of claims.
Conduct a thorough analysis of liability and continually assess exposure and evaluate for accurate reserves.
Works toward the resolution of claims files and takes full charge of claim from inception to resolution.
Will affect settlements/reserves within prescribed limits and submits recommendations to supervisor on cases exceeding personal authority.
Ensures that claims payments calculated accurately and are issued in a timely and accurate manner.
Ensures compliance of claims handling pursuant to all state legal statutory and regulatory bodies to comply with all company procedures and requirements.
Maintains a diary to follow claim progress on all claims.
Determine liability for permanent disability mitigation of costs and resolution of claim.
Oversee litigation and coordination of claim with defense team.
Qualifications:
5 years plus experience handling workers compensation claims.
Current California Adjuster Certification.
Familiarity with state workers compensation laws and regulations
Candidates willbe required to have strong skills incustomer service verbal and written communicationstime management and organizational skills.
Excellent attention to detail.
Must demonstrate an ability to work independently.
Must demonstrate a strong knowledge of computers and software.
Communication Skills:
Demonstrated ability to manage relationships in a fastpaced environment along with problem solving and decisionmaking skills to work through a variety of challenging situations.
Ability to respond to requests effectively and efficiently.
Listens effectively and clearly expresses ideas and recommendations.
Proficient in communicating effectively and clearly both orally and in writing.
Capable of carrying out detailed written or verbal instructions.
Technical Expertise:
Complete understanding of all Microsoft Office applications.
Ability to apply concepts such as fractions percentages ratios and proportions to practical situations.
Proficient in the operation of computer equipment and applications.
Customer Service:
Responds timely and consistently with all communication.
Builds credibility with internal and external customer.
Creates customer satisfaction.
Familiar with the company tools and is comfortable reviewing with all levels of management in a professional manner.
Work Environment/Hours
This role routinely uses standard office equipment such as computers phones photocopiers filing cabinets and fax machines.
Team Environment
Verbal Contact with Others
Standard Work Hours: MonFri 8:30a5p 37.5 Hours per week) Additional hours will be worked based on business needs. Adjustment from 8:30a5pm per arrangement with Management.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job the employee is regularly required to talk or hear. The employee is required to frequently sit; work using a computer; interact with customers (by phone and/or email); use hands to finger handle or feel; and reach with hands and arms.
Travel
Minimal travel is primarily local during the business day although some outofthearea and overnight travel may be expected.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee for this job. Duties responsibilities and activities may change at any time with or without notice.
Acrisure is committed to employing a diverse workforce. All applicants will be considered foremploymentwithout attention to race color religion age sex sexual orientation gender identity national origin veteran or disability status. California residents can learn more about our privacy practices for applicants by visiting the Acrisure California Applicant Privacy Policy available at Executive Search Firms & Staffing Agencies: Acrisure does not accept unsolicited resumes from any agencies that have not signed a mutual service agreement. All unsolicited resumes will be considered Acrisures property and Acrisure will not be obligated to pay a referral fee. This includes resumes submitted directly to Hiring Managers without contacting Acrisures Human Resources Talent Department.
Required Experience:
Senior IC
Employment Type
Full-Time
