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Claims Adjuster - Workers Compensation - REMOTE

  • Location: Baton Rouge, East Baton Rouge, Louisiana, 70804-0000
  • Salary: 25.0
  • Job Type:Contract to Hire

Posted 29 days ago

Long term contract Opportunity!
Title: Claims Adjuster
Location: Remote
Term: 6 Months Contract to hire

Day-to-Day Responsibilities:

  • Analyze mid- and higher-level workers compensation claims to determine benefits due; to ensure ongoing adjudication of claims within company standards and industry best practices; and to identify subrogation of claims and negotiate settlements
  • Manages workers compensation claims determining compensability and benefits due on long term indemnity claims, monitors reserve accuracy, and files necessary documentation with state agency
  • Develops and manages workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments
  • Approves and processes assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract
  • Manages subrogation of claims and negotiates settlements
  • Communicates claim action with claimant and client
  • Ensures claim files are properly documented and claims coding is correct
  • May process complex lifetime medical and/or defined period medical claims which include state and physician filings and decisions on appropriate treatments recommended by utilization review
  • Maintains professional client relationships
  • Performs other duties as assigned
  • Supports the organization's quality program(s)
  • Travels as required

Is this a good fit? (Requirements):

  • 4 years of claims management experience or equivalent combination of education and experience required
  • Working knowledge of regulations, offsets and deductions, disability duration, medical management practices and Social Security and Medicare application procedure as applicable to line of business
  • PC literate, including Microsoft Office products
  • Analytical and interpretive skillS
  • Strong organizational skill
  • Good interpersonal skills
  • Excellent negotiation skills
  • Ability to work in a team environment Ability to meet or exceed Service Expectations
  • Optional experience with US Longshore and Jones Act claims
  • Ensure to lis all licenseure
  • Bachelor's degree from an accredited college or university preferred

If this sounds like the perfect fit, Apply Today!