Medical Only Work Comp Claims Adjuster

Frankenmuth Insurance Company

1d•Remote

About The Position

Under moderate supervision and following standard procedures with some independent judgment, this position investigates, evaluates, and resolves/disposes of medical only workers compensation claims to determine the extent of company liability. This may include determination and evaluation of coverage, compensability, liability, and damage in accordance with policy provisions.

Requirements

Ability to work legally in the United States.
Two to four years related experience and/or training; or associate's degree (A.A.) from two-year college/technical school; or equivalent combination of education and related experience/training.

Responsibilities

Follows corporate policies, procedures, and fair claims handling practices.
Investigates claims to determine validity and extent of liability.
Obtains information necessary to properly investigate and evaluate each case by corresponding with agents, insureds, claimants, witnesses and others.
Reviews and evaluates documentation, including applications, reports, and statements.
Monitors appropriate claim outcomes through self-audit process.
Delivers superior customer service to policyholders and agents, ensuring appropriate and timely resolution of claims service issues.
Ensures legal, regulatory and fair claims handling compliance.
Sets or recommends reserves based on results of claim investigation.
Within defined authority, manages, evaluates and concludes claims.
Prepares and maintains claim reports.
Conducts in-depth interviews and/or scene inspections.
Attends settlement conferences and/or trials.
May serve as a member of project teams, contributing to the achievement of project objectives.
Performs other duties as assigned.