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Making Numbers Make Sense
Workers Compensation Claims Adjuster
Location
Alabama
Posted
114 days ago
Salary
$72K - $82K / year
Seniority
Senior
Job Description
Workers Compensation Claims Adjuster
MDD Forensic Accountants
• Determine compensability and extent of coverage on assigned claims. • Conduct thorough investigations, including interviews with employees, employers, and witnesses. • Obtain and review medical, hospital, police, employment, and other relevant records. • Manage EDI reporting and CMS Section 111 compliance. • Utilize approved preferred vendors and cost-containment resources. • Prepare comprehensive and accurate reports for clients and excess carriers. • Negotiate settlements with claimants and/or their attorneys. • Manage litigation strategy, legal vendors, and associated costs in accordance with account requirements. • Handle catastrophic losses, complex litigation files, and other sensitive matters. • Respond to client inquiries promptly and professionally. • Maintain required adjuster licensing and continuing education. • Stay current on jurisdictional regulations, industry trends, and best practices. • Mentor, train, and share technical expertise with team members as needed. • Perform additional duties as assigned.
Job Requirements
- Active adjuster licenses as required by jurisdiction.
- West Virginia Workers’ Compensation jurisdictional knowledge and handling experience.
- Workers’ Compensation claims handling experience.
- Strong knowledge of Workers’ Compensation laws, claims adjudication, and investigation practices.
- Extensive understanding of medical and legal terminology.
- Experience managing litigation and working with defense counsel.
- Ability to handle multi-party investigations and complex claim scenarios.
- Strong negotiation and settlement skills.
- Proficiency with claims management systems and related software applications.
- Ability to prepare clear, factual, and well-supported reports with recommendations.
- Excellent written and verbal communication skills.
- Strong organizational skills with the ability to meet time-sensitive deadlines.
- Ability to manage confidential information with discretion.
- Capacity to quickly adapt to evolving regulations and technology.
- Ability to interpret and apply multi-state laws and regulations.
Benefits
- Medical, dental, and vision plans to ensure your health and that of your family.
- A 401k plan with employer matching to help you build a secure financial future.
- Our time-off policies, including Discretionary Time Off for exempt employees and Paid Time Off (PTO) package for non-exempt employees, reflect our commitment to promoting a healthy work environment.
- Paid holidays.
- Life insurance and both short-term and long-term disability plans, providing essential financial protection for you and your loved ones.
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