The Sr. Claims Adjuster, Workers' Compensation will investigate, manage, and resolve claims in a timely, unbiased, and informed manner in compliance with policies, state laws, and regulatory performance standards.
Job responsibilities:- Knowledge of policy documents for coverage verification.
- Provide account servicing support on claim issues to policyholders including travel as required.
- Investigate, determine compensability, and manage time loss claims consistent with jurisdictional requirements.
- When necessary, attend In-Person meetings with injured workers, employers, and medical providers
- When necessary, assign investigators, attorneys, medical consultants, and others to facilitate claim determinations and plans of action.
- Follow up with injured workers, policyholders, and medical providers to monitor progress.
- Consult with attorneys regarding litigation management, settlement strategy, and claim resolution.
- Maintain electronic files necessary for documentation of the claim file including coding, contacts, financial data, and plan of action.
- Review reserves for appropriateness and file timely reports on all serious loss claims as required by ANIC policy and regulatory standards.
- Promote the team approach to case and account management.
- Perform other duties as assigned.
- Bilingual in Spanish preferred, pay differential available.
Qualifications/Competencies:- High school graduate, Bachelor's degree preferred
- 5 years or greater of Workers' Compensation adjusting experience
- In-depth knowledge of Workers' Compensation laws
- Knowledge of medical and legal terminology and procedures
- General computer skills
- Excellent written and verbal communication skills
- Strong interpersonal skills
- Effective negotiation skills
- Ability to prioritize workload to meet deadlines
- Ability to work well in a team environment
Benefits:- Employees and their families are eligible to participate in CopperPoint Insurance Companies benefit plans including medical, dental, vision, short-term disability, long-term disability, life insurance, a health savings account, a flexible spending account, and a 401k plan.
- We provide some benefits at no cost to the employee (Basic Life Insurance and AD&D at two times an employee's annual salary, Short- and Long-term Disability coverage, and Employee Assistant Plan).
- Employees will accrue 0.0769 hours of Paid Time Off (PTO) per paid hour, which may total 20 days a year. In addition, employees will also receive 10 paid holidays throughout the calendar year.
Salary Range:- $95,000.00 - $110,000.00 annually
- Compensation may vary depending on skills, experience, education, and geographical location.
- In addition to base salary, compensation may include an annual discretionary bonus.
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