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Claims Adjuster - Workers Compensation - REMOTE

  • Location: Charlotte, Mecklenburg County, North Carolina, 28269-0021
  • Salary: 32.14
  • Job Type:Contract

Posted 15 days ago

Long term contract Opportunity!
 
Title: Claims Adjuster - Workers Compensation - REMOTE
Location: Charlotte, NC 28269-0021
Term: 2 Months Contract
 
Day-to-Day Responsibilities:
· Analyse mid- and higher-level workers compensation claims to determine benefits due.
· Ensure ongoing adjudication of claims within company standards and industry best practice.
· Identify subrogation of claims and negotiate settlements.
· Manage workers compensation claims determining compensability and benefits due on long term indemnity claims, monitor reserve accuracy, and file necessary documentation with state agency.
· Develop and manage workers compensation claims' action plans to resolution, coordinates return-to-work efforts, and approves claim payments.
· Approve and process assigned claims, determines benefits due, and manages action plan pursuant to the claim or client contract.
· Manage subrogation of claims and negotiates settlements.
· Communicate claim action with claimant and client.
· Ensure 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.
· Maintain professional client relationships.
· Perform other duties as assigned.
· Support the organization's quality program(s).
· Travel as required.
 
Is this a good fit? (Requirements):
· Bachelor's degree from an accredited college or university preferred.
· Four (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.
· Work Environment: When applicable and appropriate, consideration will be given to reasonable accommodations.
· Mental: Clear and conceptual thinking ability. Excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines.
· Physical: Computer keyboarding, travel as required.
· Auditory/Visual: Hearing, vision and talking.
 
If this sounds like the perfect fit, Apply Today!