Senior Claims Adjuster II - IL, MO, KS, IN
Company: EIG Services, Inc
Location: Reno
Posted on: October 11, 2024
Job Description:
Location: United States
Requisition Number: req29
Senior Claims Adjuster II (Workers' Compensation) - 100% Remote
OpportunityMust have experience in one or more of the following
states: IL, MO, KS, INGeneral Summary:With minimal oversight, the
Senior Claims Adjuster II is responsible for timely and accurate
management of workers' compensation claims with high or
catastrophic medical and indemnity benefits, involving litigation
and complex issues and exposures.Essential Duties and
Responsibilities:
- Completes initial contacts to obtain necessary information,
verify coverage, determine compensability and develop a plan of
action. Completes and maintains claim data integrity.
- Independently analyzes case facts to establish timely and
accurate reserves using knowledge and experience with medical
disabilities and related costs, as well as judgment of extent of
disability.
- Collaborates with Corporate Claims to proactively evaluate and
mitigate high exposure, serious or catastrophic losses.
- Provides timely and appropriate customer service within
established best practices. Maintains ongoing professional
communications with all internal and external customers.
- Accurately evaluates and pays benefits in compliance with
statutory and company procedures and guidelines. Files appropriate
state forms, as needed.
- Proactively manages or coordinates medical treatment to
continue to move the claim forward. Uses internal and external
resources to contain costs and manage exposure.
- Reviews and analyzes litigation and legal issues. Directs legal
strategy and participates in preparation of the case for
litigation. Collaborates with defense attorney to move claims to
resolution.
- Completes detailed settlement analysis and recommends
appropriate settlement value, utilizing in-depth knowledge of
appropriate workers' compensation insurance principles and laws,
subrogation recoveries, offsets and deductions, claim and
disability duration, cost containment principles; including medical
management practices and Social Security and Medicare application
procedure as applicable.
- Regularly reviews caseload and proactively takes action to
guide claims efficiently and effectively to closure. Uses a high
degree of independent judgment to render accurate decisions.
- Mentors other team members and acts as a Subject Matter Expert
for legal, jurisdiction and Company needs. May handle supervisory
duties, as needed.
- Other duties may be assigned.Job Requirements:--- Superior
communication and customer service skills and proficiency in an
imaged environment.--- Demonstrated knowledge of workers'
compensation laws and ability to adhere to statutes, regulations
and company policies and practices, as well as related claim
management procedures/protocols. --- Self-motivated with the
ability to work independently with minimal direction. The ability
to multi-task and prioritize, adhere to deadlines and complete
assignments accordingly.--- Excellent analytical, problem solving
and decision-making skills. --- Ten or more years of related claims
experience including complex claims handling.--- Must have High
School Diploma or GED equivalent. --- If state certification or
license is required, must meet certification within state mandated
timeframe and maintain any required license through continuing
education.Preferred but not required:--- Bachelor's degree or
equivalent business experience preferred.--- WCCP, AIC, ARM, CPCU
or other insurance designation is a plus.An equivalent combination
of education and experience may be substituted for the requirements
listed above.Work Environment/Physical Demands:
This role is 100% REMOTE, and only open to candidates currently
located in the United States. It requires a suitable space that
provides a private and quiet workplace. This role potentially and
will routinely use office equipment such as computers, phones,
printers, and web conferencing technology as examples. --- EXPECTED
WORK HOURS: Schedules are set to accommodate the requirements of
the position and the needs of the organization and may be adjusted
as needed.--- TRAVEL: May be required to travel to off-site
location(s) to attend meetings, as necessary
- This is largely a sedentary role; however, some mobility is
required
- May work early, late, or occasional weekend hours to
accommodate business needs
- Occasional lifting of a maximum of 30lbs.
- Reasonable accommodations may be made to enable individuals
with disabilities to perform the essential functionsSalary Range:
$70,000- $100,000 and a comprehensive benefits package. Please
follow the link to our benefits page for details!
https://www.employers.com/careers/our-benefits-and-perks/About
EMPLOYERS is a dynamic, fast-growing provider of workers'
compensation insurance and services, we are seeking a goal-oriented
individual willing to put their ideas to work! We offer a positive,
challenging work environment, combined with an opportunity to build
your career as you help us grow our business, in innovative and
imaginative ways that are uniquely EMPLOYERS!Headquartered in
Nevada, EMPLOYERS attributes its long-standing success to its most
valuable resource, our employees across the United States.
EMPLOYERS is known for the quality service and expertise we provide
to our clients, and the exemplary work environment we provide for
our employees.We live and breathe our core values: Integrity,
Customer Focus, Collaboration, Initiative, Accountability,
Innovation, and Personal Fulfillment. These are the pillars that
support how we do business with our clients as well as how we treat
each other!At EMPLOYERS, you'll discover an energetic environment
that inspires top achievement. As "America's small business
insurance specialist", we have the resources, a solid reputation,
and an expanding nationwide identity to enrich your work/life and
enhance your career. #LI-Remote HP22
Compensation details: 70000-100000
PIc1162be5eacc-37248-35724846
Keywords: EIG Services, Inc, Folsom , Senior Claims Adjuster II - IL, MO, KS, IN, Other , Reno, California
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