Workers Compensation Claims Adjuster

Remote Work

Job Description:

This position can be filled as a Claim Representative or Sr. Claim Representative based on experience. The Workers’ Compensation Claim / Sr. Claim Representative is accountable for planning, recommending, and executing the investigation of workers’ compensation claims. Our dynamic team of claim professionals provide superb customer service with the valuation, disposition and settlement of worker compensation claims while consistently adhering to our corporate claim settlement policies. Additionally, the representatives will work within established procedures in adherence to statutory, regulatory and ethical requirements.

Responsibilities:
• Effectively manage workers’ compensation claims requiring timely
investigations and financial accuracy
• Provide benefit oversight, appropriate file disposition and adherence to statutory guidelines for all claims
• Leverage a network of professional resources that may include:
doctors, nurses, attorney and regulators to facilitate our mission of
restoring the lives of our claimants
• Provide exceptional customer service by establishing and maintaining productive business relationships with customers
• Utilize critical thinking skills to gather and analyze data information to inform critical claim decisions
• Provide accurate mathematical calculations of disability benefit rates and claim financial exposures
• Leverage contemporary technology to achieve accurate and efficient claim outcomes
• Consistently demonstrate professional diplomacy during all
interactions with customers
• Contribute to a courageous culture that promotes collaboration and inclusion to maximize operational performance and employee
engagement
• Embrace a culture of continuous improvement

Qualifications:
Claim Representative:
• Prior workers’ compensation insurance claim handling is preferred
• HS Diploma required, Bachelor’s Degree is preferred
• Demonstrated passion for delivering a superb customer experience
• Excellent organizational skills, especially regarding prioritizing work activities
• Strong computer proficiency in the MS Office Suite (Word, Excel,
Outlook & PowerPoint)
• Superb time management and organizational skills
• Ability to meet productivity targets in a fast-paced, team-oriented
environment
• Excellent communication skills and negotiation skills
• Ability to adapt and flourish using industry-changing workflows
• Excellent written and verbal communication skills
• Demonstrates active listening to attentively meet the needs of our
customers and exhibit empathy during difficult situations
• Demonstrated desire to promote an inclusive culture of continuous learning that is built on teamwork, collaboration, transparency, and accountability to one another
• Ability to self-manage competing priorities while delivering accurate work within key timelines

 


Key Skills:

  • Claims Adjuster, Workers compensation, Licensing in california

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