Claims Adjuster

Investigates and evaluates losses while developing a plan of action to bring claims to proper resolution in a timely manner. Experience level preferably between 3 - 5 years.

JOB REQUIREMENTS:

· Determines extent of insurance coverage and compensability for new claims,

presumption claims and pensioner claims

· Investigates claims, including interviewing employees, employers, witnesses

· Obtains necessary records, including but not limited to, hospital records, police

reports, physician records, etc.

· Utilizes appropriate preferred vendors

· Monitors/directs medical treatment

· Handles Medicare subrogation issues

· Presents thorough and accurate reports to clients

· Attends meetings; conferences; workshops or training sessions; and reviews written

material to maintain current knowledge on principles, practices and new developments in assigned work areas

· All other duties as assigned

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

· Ability to understand and follow oral and/or written policies, procedures and instructions

· Ability to perform a wide variety of duties and responsibilities with accuracy and speed, while meeting time-sensitive deadlines

· Ability to conduct investigations in multi-party situations

· Ability to use standard or customized software applications appropriate to assigned tasks

· Ability to prepare and present accurate, reliable and factual reports with recommendations

· Ability to handle confidential information

· Ability to communicate effectively with others both orally and in writing

· Ability and willingness to learn quickly and utilize new skills as a result of rapidly changing information and/or technology

· Will work onsite at local office as well as onsite with client

Required Experience:

Should have 3 - 5 years experience in handling workers’ compensation claims. A college degree or equivalent business experience needed.