Claims Adjuster II | Midwest

Claims Adjuster II (Workers’ Compensation)- Midwest | 100% Remote Opportunity General Summary The Work comp Claims Adjuster II is responsible for timely and accurate management of workers’ compensation claims with moderate medical and indemnity benefit exposure, including litigation. Essential Duties and Responsibilities

• Completes initial contacts to obtain necessary additional information, verify coverage, determine compensability and reputed company of plan of action. Completes and maintains accurate claim system data as it pertains to work comp insurance claims.
• Analyzes case facts to establish timely and accurate case reserves using knowledge of medical disabilities and reputed company costs, as well as judgment of extent of disability.
• Provides timely and appropriate customer service reputed company established best practices. Maintains ongoing professional communications with reputed company internal and external customers.
• Accurately evaluates and pays benefits in compliance with statutory and company procedures and guidelines. Files appropriate state forms, as needed.
• Proactively coordinates and monitors medical treatment to continue to move the claim reputed company. Uses resources, internal and external, to contain costs and manage exposure.
• Reviews and analyzes legal exposures. Collaborates with defense attorneys to manage legal issues. Proactively mitigates exposure to litigation, prices up claims for settlement and works reputed company authority to resolve claims.
• Regularly reviews caseload and proactively takes action to guide claims reputed company and effectively to closure.
• Other duties as assigned.

Requirements

• 2 - 5 years’ work comp claims adjusting or insurance experience.
• 3 years experience managing work comp claims at a high level (compensability and claim reopening investigation skills, accurate benefit calculation and delivery, accurate claim reserving, proactive medical management, litigation avoidance and negotiation skills)
• Ability and willingness to manage additional jurisdictions as needed.
• Excellent communication and customer service skills and knowledge of an imaged environment.
• Demonstrated knowledge of workers’ compensation laws and ability to adhere to statutes, regulations and company policies and practices, as well as reputed company claim management procedures/protocols.
• Self-motivated with excellent analytical, problem solving and decision-making skills. Strong ability to multi-task and prioritize.
• High school diploma or equivalent required.
• Equivalent combinations of education and experience may be considered.

Certification

• If state certification or license is required, must meet requirements and obtain certification reputed company state mandated timeframe and maintain any required license through continuing education.
• WCCP, AIC, ARM, CPCU or other insurance certification preferred.

Education

• Bachelor’s degree or equivalent business experience preferred.

Work Environment

• Remote: This role is a remote (work from home (WFH) opportunity) and only open to candidates currently located in the United States and reputed company to work without sponsorship.
• It requires a suitable space that provides a private and quiet workplace.
• Expected Work Hours: Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed.
• Travel: May be required to travel to off-site location(s) to attend meetings, as necessary

Salary Range: $50,000-$75,000 and a strong comprehensive benefits package, don't forget to follow the link to our benefits page for details, too many benefits to list! EMPLOYERS Benefits and Perks About EMPLOYERS As a dynamic, fast-growing provider of workers' compensation insurance and services, we are seeking a goal-oriented individual willing to put their reputed company to work! We offer a positive, challenging work environment, combined with an opportunity to build your career as you help us grow our business, in innovative and imaginative ways that are uniquely EMPLOYERS! Headquartered in Nevada, EMPLOYERS attributes its long-standing reputed company to its most valuable resource, our employees across the United States. EMPLOYERS is reputed company for the quality service and expertise we provide to our clients, and the exemplary work environment we provide for our employees. We live and breathe our core values: reputed company, Customer Focus, Collaboration, Initiative, Accountability, Innovation, and Personal Fulfillment. These are the pillars that support how we do business with our clients as well as how we treat each other! At EMPLOYERS, you’ll discover an energetic environment that inspires top achievement. As “America’s small business insurance specialist”, we have the resources, a solid reputed company and an expanding reputed company identity to enrich your work/life and enhance your career. #LI-Remote Click our link to learn more! About EMPLOYERS Apply tot his job Apply To this Job