Claims Adjuster | Workers' Compensation |
Title: Claims Adjuster | Workers' Compensation
Location: REMOTE (current New Mexico residence)
Innovative employee friendly Claims Third Party Administrator(TPA) has a brand new opening for a customer centric up and comer dedicated to New Mexico Claims handling MUST be NM residence. File counts are kept to a minimum with helpful Administrative staff and user friendly efficient software systems. Qualified Applicants MUST have recent New Mexico desk experience handling complex litigated Indemnity Claims handling experience and active Adjusters' License. Dedicated to New Mexico Files
General Description
Manage within company standards and best practices complex and problematic high visibility workers' compensation claims within delegated limited authority to determine benefits due, work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer requirements to achieve the best possible outcome in the claim.
Essential Job Duties
Receives claim, confirms policy coverage & acknowledgement of claim
Determine validity & compensability of claim by investigating & gathering info, file necessary documentation with state agencies
Establish reserves & authorize payments within reserving authority limits
Develop and manage well documented action plan with case manager, attorney, supervisor & client to reduce overall cost of claim
Coordinating early return to work efforts with case manager & employer
Negotiates settlements when necessary
Actively manage the litigation process
Identifies potential subrogation claims
Communicate claim status with customer and claimant
Adhere to client guidelines & participate in claim reviews as needed
Develops & maintains professional customer relationships
Education/Training Requirements
Degree at an accredited college or university preferred
Three years handling claims WC Lost Time
Excellent oral, written communication skills & customer service
PC literate, including Microsoft Office (Word, Excel)
Effective analytical & interpretive skills
Strong organizational skills
Great interpersonal skills
Skills: claims, workers compensation, adjuster:
Recruiter Contact [email protected]
Apply Now
Location: REMOTE (current New Mexico residence)
Innovative employee friendly Claims Third Party Administrator(TPA) has a brand new opening for a customer centric up and comer dedicated to New Mexico Claims handling MUST be NM residence. File counts are kept to a minimum with helpful Administrative staff and user friendly efficient software systems. Qualified Applicants MUST have recent New Mexico desk experience handling complex litigated Indemnity Claims handling experience and active Adjusters' License. Dedicated to New Mexico Files
General Description
Manage within company standards and best practices complex and problematic high visibility workers' compensation claims within delegated limited authority to determine benefits due, work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer requirements to achieve the best possible outcome in the claim.
Essential Job Duties
Receives claim, confirms policy coverage & acknowledgement of claim
Determine validity & compensability of claim by investigating & gathering info, file necessary documentation with state agencies
Establish reserves & authorize payments within reserving authority limits
Develop and manage well documented action plan with case manager, attorney, supervisor & client to reduce overall cost of claim
Coordinating early return to work efforts with case manager & employer
Negotiates settlements when necessary
Actively manage the litigation process
Identifies potential subrogation claims
Communicate claim status with customer and claimant
Adhere to client guidelines & participate in claim reviews as needed
Develops & maintains professional customer relationships
Education/Training Requirements
Degree at an accredited college or university preferred
Three years handling claims WC Lost Time
Excellent oral, written communication skills & customer service
PC literate, including Microsoft Office (Word, Excel)
Effective analytical & interpretive skills
Strong organizational skills
Great interpersonal skills
Skills: claims, workers compensation, adjuster:
Recruiter Contact [email protected]
Apply Now