Associate Claims Adjuster

POSITION SUMMARY: 

Under direct supervision, investigate, evaluate, negotiate, settle and learn to adjust claims in accordance with MD Workers’ Compensation Law and internal Guidelines.
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DUTIES AND RESPONSIBILITIES:
 
-    Become fluent in insurance company operations, principles of insurance, WC claims handling and specific Maryland claims handling practices.
-    Under direct supervision, investigate assigned claims following sound claims handling techniques in accordance with company claim philosophy and quality assurance standards. Review all relevant data, evaluate claims, determine coverage and compensability and negotiate settlements up to the dollar value as determined by the  Supervisor.
-    Document files with necessary reports, investigative notes, and other data as may be required by the Maryland Workers’ Compensation Law, the company and the supervisor. Keep supervisor advised on status of problem claims.
-    Manage lost time and medical management of each claim.
-    With supervision, prepare files for hearing, identify witnesses and document defense to the issues. With supervisory guidance, attend and participate in WCC hearings, mediations, settlement conferences, pre-trial hearings and fraud trials.
-    Provide superior service to policyholders, agents and the claims public. Comply with standards for service and prompt contact. Keep agents and policyholders informed of claim status as appropriate. Anticipate and promptly respond to all issues and concerns.
-    Demonstrate aptitude to see a scenario from multiple viewpoints while maintaining control of many different details that can impact an outcome.
-    Perform other duties as may be dictated by department circumstances.
-    May be assigned to training unit    
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SKILLS, EDUCATION AND EXPERIENCE: 
-    Bachelor’s Degree required and completion of internal training program
-    Basic skills using Microsoft Word and Excel.
-    Strong organizational skills
-    Internal personal skills
-    Customer service focused
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POSITIONAL COMPETENCIES: 
-    Bias for Action
-    Deliver Results
-    Personal Leadership    
-    Knowledge Sharing
-    Service and Sales Excellence
-    Teamwork and Communication
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PHYSICAL DEMANDS:

While performing the duties of this job, the employee is regularly required to sit, use hands and fingers, handle or feel objects, tools or controls; reach with hands and arms.  The employee is occasionally required to stand, walk, stoop, kneel, crouch or crawl.  The employee may occasionally lift up to 30 pounds. Specific vision abilities are required which include, close vision, peripheral vision and the ability to adjust focus.
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WORK ENVIRONMENT:

Office environment. The noise level is usually moderate.