Workers Compensation Claim Adjuster (NJ)

Ccmsi • Linwood, NJ

120d • $65,000 - $70,000 • Hybrid

About The Position

The Workers' Compensation Claim Consultant (Adjuster) is responsible for the investigation and adjustment of assigned claims, focusing on New Jersey claims. This position may serve as an advanced training opportunity for promotion to a more senior level claim position. The adjuster is accountable for the quality of claim services as perceived by CCMSI clients and within corporate claim standards.

Requirements

• Five or more years claims experience is required.
• Bachelor degree is preferred.
• Proficient using MicroSoft Office products such as Word, Excel, Outlook, etc.
• Adjuster's license may be required based upon jurisdiction.

Responsibilities

• Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws.
• Establish reserves and/or provide reserve recommendations within established reserve authority levels.
• Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims.
• Negotiate any disputed bills or invoices for resolution.
• Authorize and make payments of claims in accordance with claim procedures utilizing a claim payment program in accordance with industry standards and within established payment authority.
• Negotiate settlements in accordance with Corporate Claim Standards, client specific handling instructions and state laws, when appropriate.
• Assist in the selection, referral and supervision of designated claim files sent to outside vendors.
• Assess and monitor subrogation claims for resolution.
• Review and maintain personal diary on claim system.
• Prepare reports detailing claim status, payments and reserves, as requested.
• Compute disability rates in accordance with state laws.
• Effective and timely coordination of communication with clients, claimants and appropriate parties throughout the claim adjustment process.
• Prepare newsletter articles, as requested.
• Provide notices of qualifying claims to excess/reinsurance carriers.
• Handle more complex and involved claims than lower level claim positions with minimum supervision.
• Conduct claim reviews and/or training sessions for designated clients, as requested.
• Attend and participate at hearings, mediations, and informal legal conferences, as appropriate.
• Compliance with Corporate Claim Handling Standards and special client handling instructions as established.
• Perform other duties as assigned.

Benefits

• 4 weeks paid time off in your first year
• 10 paid holidays
• Medical, Dental, Vision, Life Insurance
• Critical Illness, Short and Long Term Disability
• 401K
• Employee Stock Ownership Plan (ESOP)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities
• Education Level: Bachelor's degree