New Mexico Workers' Compensation Adjuster (Remote in NM)

Davies • New Mexico, NM

7d • Remote

About The Position

Davies North America is seeking an experienced Workers' Compensation Adjuster to join their team. The role involves investigating and evaluating losses, developing action plans for timely claim resolution, and requires the candidate to reside in New Mexico and possess a New Mexico adjuster license. This position is remote within New Mexico.

Requirements

• Live in New Mexico
• New Mexico adjuster license
• Minimum of 5-7 years of experience handling Workers' Compensation claims
• 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
• Extensive knowledge of medical and legal terminology with a thorough understanding of Legal principles/litigation management
• Ability to handle confidential information
• Ability to communicate effectively with others both orally and in writing
• Ability and willingness to learn quickly and utilize new skills because of rapidly changing information and/or technology
• Ability to comprehend multi-state laws and regulations to assist other offices, as necessary

Responsibilities

• Determines extent of insurance coverage and compensability on each filed claim
• Investigates claims, including interviewing employees, employers and witnesses
• Obtains necessary records, including but not limited to, hospital records, police reports, physician records, etc.
• EDI and CMS/Section 111 reporting
• Utilizes appropriate preferred vendors
• Presents thorough and accurate reports to client and/or carrier on claims investigations/situations
• Negotiates settlements for resolutions with claimants and their attorneys
• Maintains control of litigation activities and costs per account requirements
• May be asked to mentor, train and/or share expertise with other Davies staff
• 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 specific licensing requirements
• Responds to client questions and comments in a courteous and timely manner
• Is responsible for catastrophic losses, complex litigation, and other sensitive issues
• All other duties as assigned
• Maintain regular and dependable attendance.
• Be available and able to perform job responsibilities during established work hours.

Benefits

• Medical, dental, and vision plans
• A 401(k) plan with employer matching
• Discretionary Time Off (DTO) for exempt employees
• Paid Time Off (PTO) for non-exempt employees
• Paid holidays
• Life insurance
• Short-term and long-term disability coverage
• Paid sick leave
• Paid family and parental leave

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed