Job Description
Job Requirements/Responsibilities:
- 3+ years experience working directly for an Insurance Carrier or Third Party Administrator
- 3+ years experience handling Workers’ Compensation claims
- Must possess current North Carolina or South Carolina claims adjuster licenses
- Additional licenses a plus
- Duties to include but not limited to mid to high-level Workers’ Compensation claims to determine benefits due; to insure ongoing adjudication of claims within company standards and industry best practices
- Ability to manage subrogation of claims and negotiate settlements
- Responsible for claims management of assigned caseloads from medium to high complexity and/or moderate exposure claims, within the guidelines of published performance standards
- Analyze claims, set reserves, determine compensability, pay benefits and settle claims within established dollar authority and according to company policy and Labor Code provisions
- Assign rehabilitation referrals including early return-to-work programs
- Maximize utilization of company medical cost containment programs
- Prepare cases in litigation adequately and appropriately for MSCs and trials
- Communicate with policyholders, injured workers and others in a professional and timely manner
- Responsible for meeting specific performance objectives
- May function as an account coordinator to specific policyholders
- Settlement/reserve authority as established by management
- Strong analytical, interpretive, organizational, negotiating and interpersonal skills
- Attend educational seminars and classes as assigned
Job Requirements
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