Sr. Adjuster-Workers Comp Claims
About The Position
CopperPoint has an exciting opportunity for a fully remote Workers’ Compensation Claims Adjuster Senior, Indemnity. The ideal candidate must possess Arizona jurisdiction technical claims knowledge. Additional experience in MO, KS, CO, UT, NM, NV and/or TX jurisdictions is preferred. The Workers’ Compensation Claims Adjuster Senior, Indemnity is responsible for analyzing time loss workers’ compensation claims to determine compensability. They will also adjudicate claims to ensure timely payment of indemnity and medical benefits due within company standards and in compliance with regulatory requirements, as well as establishing and maintaining action plans and reserves to ensure proactive, cost-effective claims management.
Requirements
- At least 3 years prior experience handling/adjusting workers’ compensation claims.
- Arizona workers’ compensation claims management experience is required.
- Excellent customer service skills to include initiative, mature judgement and discretion.
- Strong technical workers’ compensation knowledge with prior successful experience in a workers' compensation as well as other commercial lines claims management environment.
- Knowledge of Department of Insurance (DOI), NCCI, Department of Labor and Employment (CDLE) rules and regulations.
- Ability to analyze, interpret and apply laws, rules and regulations pertaining to workers’ compensation.
- Ability to stay current with changes to statutory, industry rules and regulations as well as company policies and procedures which may impact claims management.
- Ability to set priorities, manage time, organize work and meet deadlines.
Nice To Haves
- Bachelor's degree (B. S. or B.A.) in business administration, communications, or a related field from an accredited four-year college or university is preferred.
- Experience/licensure in one or more of the other states in our region is highly preferred (MO, CO, UT, KS, NM, NV, OK and/or TX)
- Bilingual in Spanish preferred.
Responsibilities
- Analyze and investigate indemnity claims to determine compensability decisions by interpreting and applying laws, rules, and regulations of workers’ compensation.
- Utilize all available resources as appropriate.
- Build and maintain professional relationships with injured workers, policy holders, brokers and agents through proactive claim management and timely communications.
- Appropriately document communications and claim management activities.
- Develop, maintain and adhere to action plans and reserves on indemnity claims while proactively managing claims to resolution.
- Establish and maintain cost drivers and data elements to ensure accurate NCCI and Medicare reporting.
- Proactively manage claims in accordance with company standards and statutory requirements.
- Ensure timely payment of indemnity and medical benefits.
- Actively utilize all available cost containment measures and programs.
- Identify settlement opportunities.
- Negotiate settlements with claimants and attorneys. Conducts dispute resolution with claimants and attorneys.
- Testify at hearings when necessary.
Benefits
- Medical insurance
- Dental insurance
- Vision insurance
- Short-term disability
- Long-term disability
- Life insurance
- Health savings account
- Flexible spending account
- 401k plan
- Basic Life Insurance and AD&D at two times an employee’s annual salary
- Employee Assistant Plan
- Paid Time Off (PTO)
- Paid holidays
- Tuition reimbursement
- Other education benefits
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What This Job Offers
Job Type
Full-time
Career Level
Senior
