Claims Adjuster - Workers CompensationPRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.Negotiates settlement of claims within designated authority.Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles claims within designated authority level.Prepares necessary state filings within statutory limits.Manages the litigation process; ensures timely and cost effective claims resolution.Coordinates vendor referrals for additional investigation and/or litigation management.Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.Ensures claim files are properly documented and claims coding is correct.Refers cases as appropriate to supervisor and management.ADDITIONAL FUNCTIONS AND RESPONSIBILITIES:Performs other duties as assigned.Supports the organization's quality program(s).Travels as required.QUALIFICATION:Education & Licensing: Bachelor's degree from an accredited college or university preferred. Professional certification as applicable to line of business preferred.Experience: Five (5) years of claims management experience or equivalent combination of education and experience required.Location: Pasadena, CA
...Job Description Job Description Physiatrist Location: Little Falls, MN Schedule: Full-Time (5 Days/ week) Total Compensation: $150,000- $200,000 About MedElite Since 2011, MedElite has been dedicated to improving the standard of care in skilled nursing...
...ago. Were a purpose-driven locum tenens and permanent placement staffing company that actively staffs over 150 amazing rural and remote locations in the northwest United States and Alaska. Apply here, learn more by visiting , or contact a recruiter today to inquire...
...CW stations. At the doorstep of the Smoky Mountains and on the banks of the Tennessee River, Knoxville is the 61st largest television... ...for an experienced and accomplished full-time Multimedia Executive responsible for selling our three television stations, as well...
...motivator? Have you always wanted to have the power to be hands-on and develop an amazing culture in your workplace? As the Spa Manager, you will direct and organize the overall operation of the spa to maximize profits through exemplary customer service and customer...
...emergency physicians who will become leaders in clinical care, research, teaching, and administration. The University of Pittsburgh and UPMC are top tier institutions by virtually all metrics, fostering excellence and innovation while caring about those we serve. Our...