Adjuster Jobs

About The Position

Requirements

• Associate’s degree in business or a related field is required
• Current North Carolina Claims Adjuster's License and in good standing required
• Valid North Carolina driver’s license required
• 4 years’ experience in workers' compensation claims administration required
• Proficiency in reading, writing, and speaking the English language
• Knowledge of North Carolina workers' compensation law
• Understanding of litigation processes and importance of documentation
• Knowledge of OSHA regulations
• Ability to work with people in a professional, tactful, and diplomatic way
• Ability to work independently and accomplish tasks in timely manner
• Ability to organize and prioritize activities and tailor procedures to a smoothly functioning department
• Ability to work with variety of changing activities from entering data into computer database to making highly technical decisions
• Ability to hold in confidence highly sensitive information and materials
• Proficiency with Microsoft Office software (e.g., Outlook, Word, Excel, etc.)
• Proficiency with the use of a claims database, e.g., iVOS or another insurance carrier’s database

Nice To Haves

• Bachelor’s degree preferred
• 3 years’ of experience in safety, legal, and insurance environment preferred

Responsibilities

• Investigate and analyze data to determine compensability in accordance with the NC Workers’ Compensation Act
• Manages assigned workers' compensation claims in a timely manner
• Attend workers' compensation mediations and NC Industrial Commission hearings as required
• Independently works within certain limits and authority to actively manage a caseload of complex lost time cases
• Establish claim reserves, propose and negotiate settlements under the supervision of the Workers’ Compensation Program Manager
• Approve disability and medical payments and other expenses related to workers' compensation claims
• Review employee incident report to determine which employee injury/illness incidents meet OSHA recordability criteria and documents individual files in database accordingly
• Prepares NC Industrial Commission forms and dispatches them to responsible parties
• Collect, enter, and update information in workers' compensation software database
• Maintain claims diary and completes diary items in timely manner
• Review and verify bills for services provided in conjunction with workers' compensation program and individual claims
• Authorize check requests for workers' compensation benefits, medical payments, case management bills, settlement checks in addition to other miscellaneous expenses
• Assist with preparation for workers' compensation legal proceedings
• Keeps current with laws and regulatory requirements related to workers' compensation and OSHA to assist the Health System in maintaining compliance with same
• Maintain strict confidentiality of all documentation, information, and work-product
• Other duties as assigned