Workers' Compensation Claim Adjuster

CCMSI
Maitland, FL
Category Human Resources
Job Description
CCMSI is seeking a Workers' Compensation Claim Adjuster to investigate, evaluate, and adjust claims in accordance with established standards and client needs. The role involves maintaining client satisfaction, preparing reports, and participating in hearings. This is an advanced training position for potential candidates, offering career development and recognition.

Requirements

  • Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
  • Establish reserves and/or provide reserve recommendations within established reserve authority levels.
  • Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices.
  • Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program.
  • Negotiate settlements in accordance within Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
  • Prepare reports detailing claim status, payments and reserves, as requested.
  • Assist in the selection, referral and supervision of designated claim files.
  • Assess and monitor subrogation claims for resolution.
  • Conduct claim reviews and/or training sessions for designated clients.
  • Attend and participate at hearings, mediations, and informal legal conferences.
  • Ensure compliance with Corporate Claim Handling Standards and special client handling instructions.

Benefits

  • Medical
  • Dental
  • Vision
  • Life Insurance
  • 401K
  • ESOP
  • Flexible Spending
  • Short and Long Term Disability
  • Relocation Assistance
  • Paid Time Off
]]>