WC Claim Adjuster
Location: Mechanicsburg, Pennsylvania
Description: Alternative Service Concepts, LLC is at present recruited WC Claim Adjuster right now, this occupation will be presented in Pennsylvania. More details about this occupation opportunity please read the description below. SUMMARY
Investigates and evaluates losses while developing a plan of action to bring claims to proper resolution in a timely manner. Experience in multi-state juris! dictions helpful.
JOB REQUIREMENTS:
EDI and CMS/Section 111 reporting
Determines extent of insurance coverage and compensability on each filed claim
Investigates claims, including interviewing employees, employers, witnesses
Obtains necessary records, including but not limited to, hospital records, police reports, physician records, etc.
Utilizes appropriate preferred vendors
Presents thorough and accurate reports to clients and excess carriers on claims investigations/situations
Negotiates settlements for resolutions with claimants and their attorneys
Maintains control of litigation activities and costs per account requirements
Attends meetings; conferences; workshops or training sessions; and reviews written material to maintain current knowledge on principles, practices and new developments in assigned work areas
Maintains and meets state specific licensing requirements
Responds to client questions and comments in a courteo! us and timely manner
All other duties as assigned
REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:
Ability to understand and follow oral and/or written policies, procedures and instructions
Ability to perform a wide variety of duties and responsibilities with accuracy and speed, while meeting time-sensitive deadlines
Ability to conduct investigations in multi-party situations
Ability to use standard or customized software applications appropriate to assigned tasks
Ability to prepare and present accurate, reliable and factual reports with recommendations
Thorough knowledge of current principles and practices associated with claims investigations, adjustment and related practices including appropriate State and Federal statutes
Extensive knowledge of medical and legal terminology with a thorough understanding of legal principles/litigation management
Ability to handle confidential information
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Ability to communicate effectively with others both orally and in writing
Ability and willingness to learn quickly and utilize new skills as a result of rapidly changing information and/or technology
Required Experience:
Should have 3 - 5 years experience in handling workers’ compensation claims. A college degree or equivalent business experience needed.
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If you were eligible to this occupation, please deliver us your resume, with salary requirements and a resume to Alternative Service Concepts, LLC.
Interested on this occupation, just click on the Apply button, you will be redirected to the official website
This occupation will be started on: Sun, 10 Mar 2013 13:54:23 GMT