Claims Adjuster - WC

As the result of increasing workloads, we are currently seeking candidate to expand our team as a Claims Adjuster to handle worker’s compensation claims. Past experience in managing these types of claims is essential. Our office locations are Philadelphia, PA and Quincy, MA.  Position may also be remote.  Compensation is competitive and will be commensurate with the candidate’s qualifications and experience.

Key Objectives:

This will be a full time/permanent post to work on a portfolio of run-off business which includes worker’s compensation claims as well as Personal Injury Protection claims. You will be responsible for handling and resolving claims. This includes determining case strategy, analyzing liabilities as well as setting appropriate reserves, negotiating settlements, dealing with counterparties effectively, and ensuring payments are timely processed and providing management reporting on claims.

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Workers Compensation Claims adjuster to handle claims from multiple jurisdictions including but not limited to New York, Texas, Connecticut, California, Florida, New Jersey, Pennsylvania.

• Analyze worker’s compensation claims to determine benefits due; work with claims involving litigation and rehabilitation; identify subrogation claims and negotiate settlements.

• Utilization of cost containment protocols to include Second Injury Fund submissions.

• Monitor reserve adequacy and update reserves as appropriate within authority level.

• Interact positively with agents and other external parties.

• Document claim system file in a clear manner.

• Draft claim status reports for claim file and client to request authority as well as periodic filing requirement.

• Compliance with regulatory rules to include familiarity with state EDI submissions.

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• Resilient and flexible, with the ability to adapt to work to short/changing deadlines.

• Ability to effectively and confidently manage multi-party relationships with complex claim negotiations.

• Self-motivated and able to motivate others.

• Maintains professional and technical knowledge through training, networks and professional qualifications.

• Accurate and reliable with excellent attention to detail and an analytical approach.

Education and Experience:

• Bachelor’s degree preferred or equivalent experience.

• Minimum of 5 years claims handling experience.

• Ability to work independently.

• Strong negotiation skills.

• Ability to work well with external parties as well as co-workers.

• Excellent verbal and written communication skills.

• Proficiency with current Microsoft Outlook and Office products.  

• NY adjusters license required.

• Willingness to obtain needed licenses via testing protocol if statutorily required

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