Job Brief
We are seeking a detail-oriented Workers Compensation Claims Adjuster with a strong understanding of insurance policies and claims processing. The ideal candidate will be responsible for evaluating and settling workers’ compensation claims while ensuring compliance with company practices and legal regulations. A successful Workers Compensation Claims Adjuster will possess excellent analytical skills, attention to detail, and effective communication abilities, enabling them to confer with legal counsel on claims that require litigation.
Responsibilities
- Review and analyze workers’ compensation claims to ensure payments and settlements align with company policies.
- Conduct thorough investigations into claims, gathering relevant documentation and evidence.
- Assess liability and coverage, determining the validity of claims while adhering to legal requirements.
- Negotiate settlements with claimants and legal representatives to resolve disputes efficiently.
- Maintain accurate records of claims processing and settlement agreements in compliance with regulatory standards.
- Collaborate with medical professionals, employers, and legal counsel to manage complex cases effectively.
- Stay updated on industry regulations and best practices related to workers’ compensation and insurance claims.
- Provide exceptional customer service to claimants, addressing inquiries and guiding them through the claims process.
Requirements
- Bachelor’s degree in Business Administration, Finance, or a related field is preferred.
- Minimum of 2 years of experience in workers’ compensation claims adjusting or a related insurance role.
- Strong knowledge of workers’ compensation laws, regulations, and industry practices.
- Proficient in claims management software and Microsoft Office Suite.
- Excellent analytical, negotiation, and problem-solving skills.
- Strong written and verbal communication skills, with the ability to interact professionally with various stakeholders.
- Ability to work independently and manage multiple claims simultaneously.
- Certification as a Workers Compensation Claims Adjuster (preferred but not required).
Similar Job Titles
- Claims Adjuster
- Workers Compensation Specialist
- Insurance Claims Examiner
- Claims Analyst
- Workers Compensation Analyst
- Insurance Adjuster
- Claims Representative
- Claims Manager
