Professional Search Looking for Workers Compensation Claims Adjuster – Charlotte, NC at Charlotte, North Carolina Full Time

– FULLY REMOTE OPTION, negotiable.

Requirements:
Jurisdictions to be handled are NC, SC, TN, DE, MD, VA, GA, FL.
Seeking an experienced WC Examiner for multiple jurisdictions and that can handle litigated files.

PRIMARY PURPOSE: To analyze complex or technically difficult workers’ compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

ESSENTIAL FUNCTIONS and RESPONSIBILITIES

• Analyzes and processes complex or technically difficult workers’ compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.
• Negotiates settlement of claims within designated authority.
• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.
• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.
• Prepares necessary state fillings within statutory limits.
• Manages the litigation process; ensures timely and cost effective claims resolution.
• Coordinates vendor referrals for additional investigation and/or litigation management.
• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
• Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
• Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.
• Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.
• Ensures claim files are properly documented and claims coding is correct.
• Refers cases as appropriate to supervisor and management.

ADDITIONAL FUNCTIONS and RESPONSIBILITIES

• Performs other duties as assigned.
• Supports the organization’s quality program(s).
• Travels as required.

QUALIFICATION

Education & Licensing
Bachelor’s degree from an accredited college or university preferred.

State Adjusting Licensure, required.

Experience
Four (4) years of claims management experience or equivalent combination of education and experience required.

Job Type: Full-time

Pay: $56,000.00 – $80,000.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Parental leave
• Professional development assistance
• Referral program
• Relocation assistance
• Retirement plan
• Tuition reimbursement
• Vision insurance

Schedule:

• 10 hour shift
• 8 hour shift
• Monday to Friday

Education:

• Bachelor’s (Preferred)

Experience:

• Workers’ Compensation Adjusting: 4 years (Required)

License/Certification:

• State Adjusters License (Required)

Work Location: One location