Work Comp Claims Adjuster
Work Comp Claims Adjuster
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Job Description
Job Description
Workers Compensation Claims Adjuster
Job Summary:
Seeking an experienced Workers Compensation Claims Adjuster to manage the full lifecycle of injury-related claims. This role involves evaluating coverage determining compensability negotiating resolutions and collaborating with injured employees employers legal representatives and medical professionals to ensure efficient and compliant claim handling.
Responsibilities:
- Receive and initiate handling of newly reported claims
- Determine compensability and coverage based on investigation and documentation
- Maintain accurate claim notes and records throughout the life of each claim
- Conduct interviews with claimants employers medical providers and witnesses to verify claim details
- Communicate claim decisions to all involved parties
- Set and adjust reserves appropriately based on injury severity and case development
- Calculate and schedule maintenance payments; manage ongoing diaries for future payments
- Coordinate return-to-work efforts and maintain regular communication with all stakeholders
- Review and process medical bills for additional discount opportunities through internal systems
- Collaborate with defense counsel on litigated claims supplying required documentation and case updates
- Review and approve legal invoices within designated authority levels
- Lead client-facing claim reviews as requested
Qualifications/Requirements:
- 35 years of Jones Act claims adjusting experience required
- In-depth knowledge of Federal Jones Act regulations
- Strong understanding of medical terminology and treatment progression
- Proficiency in Microsoft Office applications
- Excellent written and verbal communication skills
- Strong organizational skills and attention to detail
- Demonstrated negotiation and settlement abilities
- Commitment to high-quality customer service and timely communication
- Ability to adapt to new technologies and claims systems
- Ability to build and maintain effective working relationships across internal and external stakeholders
Compensation Package:
- Compensation: Between $75K - $100K (based on experience)
- Competitive benefits package paid time off professional development opportunities etc.
Disclaimer: Please note that this job description may not cover all duties responsibilities or aspects of the role and it is subject to modification at the employers discretion.
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Employment Type
Full-Time
