Claims Adjuster I

North Dakota Workforce Safety & Insurance; Bismarck (ND); Presencial; USD 52 000 - 68 000; Tempo integral

Resumo da oferta

North Dakota Workforce Safety & Insurance is seeking a Claims Adjuster to guide injured workers through the ND workers’ compensation claim process from report to return to work. You will review records, make eligibility decisions, and coordinate benefits with workers, employers, providers, and partners.

Responsibilities include reviewing injury reports, determining eligibility, applying ND laws, managing treatment reviews, and preparing notices/documents.

Qualificações

• High school diploma or GED plus four years of work experience in medical/insurance claims or terminology.
• College-level coursework can substitute for experience on a year-for-year basis.

Responsabilidades

• Review injury reports, medical records to determine eligibility for benefits.
• Make claim decisions based on North Dakota workers' compensation laws and regulations.
• Review medical treatment and disability information to determine benefits/payments.
• Monitor treatment and support a safe return to work for injured workers.
• Respond to questions, explain claim decisions, and help resolve claim-related issues.
• Research and gather information to make informed decisions.
• Prepare claim notices, correspondence, and other required documentation.

Conhecimentos

Engaging

Professional

Confident

Forward-thinking

Supportive

Formação académica

High school diploma or GED

College coursework substitute for experience

Descrição da oferta de emprego

Summary Of Work

As a Claims Adjuster, you'll help guide injured workers through the claim process from the initial report through treatment and return to work. You'll review information, make claim decisions, coordinate benefits, and work with injured workers, employers, medical providers, and other claim partners throughout the process. Responsibilities include:

• Review injury reports, medical records, and other information to determine eligibility for benefits
• Make claim decisions based on North Dakota workers' compensation laws and regulations
• Review medical treatment, services, and disability information to determine appropriate benefits and payments
• Monitor treatment and work with injured workers, employers, and medical providers to support a safe return to work
• Respond to questions, explain claim decisions, and help resolve claim-related issues
• Research and gather information needed to make informed decisions
• Prepare claim notices, correspondence, and other required documentation

Minimum Qualifications

• Requires a high school diploma or GED and four years of work experience that provided knowledge of medical and insurance claims and/or terminology.
• College-level coursework in a business or healthcare field will substitute for the experience requirement on a year-for-year basis.

Preferred Qualifications

• WSI holds our agency culture in high regard. The desired applicant must be engaging, professional, confident, forward-thinking, and supportive.

About Team ND

"Far and away the best prize life offers is the chance to work hard at work worth doing." - Theodore Roosevelt

More than 7,500 talented, hard-working people across sixty-three agencies have come together as Team North Dakota. At Team ND, we are driven to succeed through gratitude, humility, curiosity and courage. Our purpose is to empower people, improve lives, and inspire success. Join us in being legendary.

Total Rewards: The State of North Dakota is committed to providing team members with a strong and competitive rewards package that support you, your health and your family.

Considering a new position on Team ND? How does your current position stack up? Use our Total Rewards Calculator to estimate.

Questions or Accommodations?

Contact Madison Lein, Human Resources Generalist

[e-mail] | [phone]

Equal Employment Opportunity

The State of North Dakota and this hiring agency do not discriminate on the basis of race, color, national origin, sex (including sexual orientation and gender identity), genetics, religion, age or disability in employment or the provisions of services and complies with the provisions of the North Dakota Human Rights Act.

As an employer, the State of North Dakota prohibits smoking in all places of state employment in accordance with N.D.C.C. Sect. 23-12-10.