Workers Compensation Claim Adjuster (New Hampshire, Vermont)

Ccmsi • Manchester, NH

11d • $55,000 - $65,000 • Hybrid

About The Position

As a leading Third Party Administrator in self-insurance services, we are united by a common purpose of delivering exceptional service to our clients. As an Employee-Owned Company, we focus on developing our staff through structured career development programs, rewarding and recognizing individual and team efforts. Certified as a Great Place To Work, our employee satisfaction and retention ranks in the 95th percentile. The Workers' Compensation Claim Consultant is responsible for the investigation and adjustment of assigned claims. This position may be used as an advanced training position for consideration of promotion to a more senior level claim position. Accountable for the quality of claim services as perceived by CCMSI clients and within our corporate claim standards.

Requirements

• Five or more years claims experience is required.
• Active VT Adjusters' License
• Proficient using Microsoft Office products such as Word, Excel, Outlook, etc.
• Adjuster's license may be required based upon jurisdiction

Nice To Haves

• Bachelor degree is preferred.
• Experience adjusting NH indemnity and complex workers' compensation claims

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 within 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. (i.e. legal, surveillance, case management, etc.)
• Assess and monitor subrogation claims for resolution.
• Review and maintain personal diary on claim system.
• Client satisfaction.
• 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.
• Performs other duties as assigned.

Benefits

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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees