Sr. Adjuster-Workers Comp Claims
About The Position
CopperPoint is a specialty insurance company with deep expertise in Workers' Compensation and a growing Property and Casualty offering. They are expanding into the Southeast with a brand-new presence in Alpharetta, Georgia. This role involves leveraging knowledge and experience handling workers’ compensation claims across Georgia, Florida, North Carolina, and South Carolina to analyze time-loss claims and determine compensability. The adjuster will adjudicate claims to ensure timely and accurate payment of indemnity and medical benefits in accordance with company standards and regulatory requirements, while establishing and maintaining action plans and reserves to support proactive, cost-effective claims management. Candidates residing within 50 miles of our Georgia office will work in a hybrid environment.
Requirements
- At least three years of prior experience handling or adjusting workers’ compensation claims.
- Prior WC claims handling experience.
- Excellent customer service skills, including initiative, mature judgment and discretion.
- Strong technical workers’ compensation knowledge with prior successful experience in workers’ compensation and other commercial lines claims management environments.
- 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 and industry rules and regulations, as well as company policies and procedures that 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.
- WC claims handling experience in all our targeted states of FL, GA, NC, SC.
- Expertise for other eastern jurisdictions.
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.
- Conduct 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 (at no cost to the employee)
- Short- and Long-term Disability coverage (at no cost to the employee)
- Employee Assistant Plan (at no cost to the employee)
- Paid Time Off (PTO)
- 10 paid holidays
- Tuition reimbursement
- Other education benefits
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What This Job Offers
Job Type
Full-time
Career Level
Senior
