Lost Time Adjuster/ Sr. Lost Time Adjuster

Acrisure • Bradenton, FL

8d

About The Position

Overview : The Workers’ Compensation Claims Adjuster must be knowledgeable of the California Labor Code and administration of claims. It is the responsibility of a Workers' Compensation Claims Adjuster to receive and organize all documents related to the employee and the injury to make a determination regarding the claim. The Claims Adjuster is responsible for the prompt and efficient examination and investigation of claims. Workers' Compensation Claims Adjusters abide by company guidelines when making claim determinations. This role requires excellent communication and customer service skills, strong motivation and organizational skills. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Responsibilities: Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud, and claim resolution. Complete quality investigations by gathering pertinent information. Reviews and evaluates coverage and/or liability. Secures necessary information (i.e., reports, policies, releases, statements, or other documents) in the investigation of claims. Conduct a thorough analysis of liability and continually assess exposure and evaluate for accurate reserves. Works toward the resolution of claims files and takes full charge of claim from inception to resolution. Will affect settlements/reserves within prescribed limits and submits recommendations to supervisor on cases exceeding personal authority. Ensures that claims payments calculated accurately and are issued in a timely and accurate manner. Ensures compliance of claims handling pursuant to all state, legal, statutory, and regulatory bodies to comply with all company procedures and requirements. Maintains a diary to follow claim progress on all claims. Determine liability for permanent disability, mitigation of costs and resolution of claim. Oversee litigation and coordination of claim with defense team.

Requirements

• 5 years plus experience handling workers’ compensation claims.
• Current California Adjuster Certification.
• Familiarity with state workers’ compensation laws and regulations
• Candidates will be required to have strong skills in customer service, verbal and written communications, time management, and organizational skills.
• Excellent attention to detail.
• Must demonstrate an ability to work independently.
• Must demonstrate a strong knowledge of computers and software.
• Demonstrated ability to manage relationships in a fast-paced environment along with problem solving and decision-making skills to work through a variety of challenging situations.
• Ability to respond to requests effectively and efficiently
• Listens effectively and clearly expresses ideas and recommendations.
• Proficient in communicating effectively and clearly, both orally and in writing.
• Capable of carrying out detailed written or verbal instructions.
• Complete understanding of all Microsoft Office applications.
• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
• Proficient in the operation of computer equipment and applications
• Responds timely and consistently with all communication.
• Builds credibility with internal and external customer.
• Creates customer satisfaction.
• Familiar with the company tools and is comfortable reviewing with all levels of management in a professional manner.

Responsibilities

• Assess coverage and review claims for purposes of investigations, action plans, evaluation, fraud, and claim resolution.
• Complete quality investigations by gathering pertinent information.
• Reviews and evaluates coverage and/or liability.
• Secures necessary information (i.e., reports, policies, releases, statements, or other documents) in the investigation of claims.
• Conduct a thorough analysis of liability and continually assess exposure and evaluate for accurate reserves.
• Works toward the resolution of claims files and takes full charge of claim from inception to resolution.
• Will affect settlements/reserves within prescribed limits and submits recommendations to supervisor on cases exceeding personal authority.
• Ensures that claims payments calculated accurately and are issued in a timely and accurate manner.
• Ensures compliance of claims handling pursuant to all state, legal, statutory, and regulatory bodies to comply with all company procedures and requirements.
• Maintains a diary to follow claim progress on all claims.
• Determine liability for permanent disability, mitigation of costs and resolution of claim.
• Oversee litigation and coordination of claim with defense team.

Benefits

• Comprehensive medical insurance, dental insurance, and vision insurance; life and disability insurance; fertility benefits; wellness resources; and paid sick time.
• Generous paid time off and holidays; Employee Assistance Program (EAP); and a complimentary Calm app subscription.
• Immediate vesting in a 401(k) plan; Health Savings Account (HSA) and Flexible Spending Account (FSA) options; commuter benefits; and employee discount programs.
• Paid maternity leave and paid paternity leave (including for adoptive parents); legal plan options; and pet insurance coverage.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees